Exercise Isn't What You Think It Is Anymore with Renee Rogers

James Hill:
Welcome to Weight Loss And, where we delve into the world of weight loss. I'm Jim Hill.

Holly Wyatt:
And I'm Holly Wyatt. We're both dedicated to helping you lose weight, keep it off, and live your best life while you're doing it.

James Hill:
Indeed, we now realize successful weight loss combines the science and art of medicine, knowing what to do and why you will do it.

Holly Wyatt:
Yes, the “And” allows us to talk about all the other stuff that makes your journey so much bigger, better, and exciting.

James Hill:
Ready for the “And” factor?

Holly Wyatt:
Let's dive in.

James Hill:
Here we go.

Holly Wyatt:
Jim, for years, the public message out there has been that exercise is a key driver of weight loss. But in our work, and we talk about the science around this, there's often been a more nuanced story.

James Hill:
You know, Holly, this whole conversation around exercise just frustrates the heck out of me. People just don't get it. We've long argued that while exercise has many benefits, it's often more critical for weight loss maintenance than for weight loss. People want to say, go ahead and walk a little better and you can lose 50 and 60 pounds. Exercise is critical, but we have to put it in perspective.

Holly Wyatt:
But now, Jim, we're in a completely new era, and that's what excites me. With these GLP-1 medications, people are losing significant amounts of weight, largely through appetite regulation, largely through eating less calories, not through burning more. And they're doing this without increasing physical activity sometimes.

James Hill:
It leads us to the conversation today. The medications are driving weight loss. And let's face it, Holly, they can do it way better than you and I have been able to do it. And we've been trying for decades. And we welcome that. Let the medications drive the weight loss. Now the fun part, the good stuff, the exciting stuff comes into play. And the question we're going to ask today is, what's the role of exercise in all this? As everybody's on a GLP-1 med, should we forget about exercise? Do we need it? Is it important? This is what we're going to look at.

Holly Wyatt:
We're going to look at, does exercise become less important with the GLP-1s or what we're kind of dealing with? Or does it become even more important just for different reasons?

James Hill:
Good question. So what we're doing is we're entering a new relationship with exercise. Think about that, Holly, our relationship with exercise is changing. We have a relationship now that focuses less on weight loss alone. Gosh, the conversation around muscle and fat-free mass and muscle and losing muscle, metabolism, function, and our favorite, long-term weight loss maintenance.

James Hill:
To help us unpack this, we're joined by Dr. Renee Rogers. Renee is a senior scientist at the University of Kansas Medical Center and an expert in biobehavioral healthy lifestyle interventions and engagement strategies that support long-term adherence. Her work focuses on developing and translating innovative health promotion, physical activity, and weight management programs into real-life practice. Renee's a fellow of the American College of Sports Medicine, and she chairs both the Strategic Health Initiative for Behavior and the International Health and Fitness Summit. She's a frequent invited speaker on health promotion, engagement, and intervention design. Renee, we're thrilled to have you with us. Welcome to Weight Loss And.

Renee Rogers:
Thank you. I'm really excited to be here. It's a great conversation, great topic.

Holly Wyatt:
Yeah, you're the perfect speaker for this. Renee, let's start with the big picture, because that's what excites me about having you on. We're in this moment where weight loss is changing rapidly, and with that, there's this opportunity. The role of exercise may be changing too. And you've written and spoken about this, especially around these GLP-1 medications, how this may be reshaping the relationship. And that's what I really want to talk about today. So help us understand what you mean by that, reshaping kind of the relationship with exercise.

Renee Rogers:
Yeah, I love to think about it, you know, summarizing the simple word is it's an opportunity. And I think for many, even fitness professionals out there, and for those of us that have worked in obesity care, and especially from my lens as an exercise physiologist in the space, is I've watched decades of work where, you know, when metabolic bariatric surgery was, you know, it's boom time. We were saying lifestyle versus metabolic bariatric surgery, which one's better? This versus that. And now we're in this age when GLP-1 first hit, even though all of us recognize that we've been studying it for 25 years. It's been out there. We're just in these latest iterations of it that immediately the response was, well, it's lifestyle versus pharmacotherapy, right? This versus that again. The same thing has happened. And really stepping back and saying, hold up. This is an opportunity, like you all said, to allow for something else to be the focus for weight loss and not try to oversell the role that exercise plays in the relationship.

James Hill:
I love it. And again, these meds are so effective at weight loss. And as you know, there are other ones coming down the road. So I believe that within maybe a year, two years, there's going to be a medication that will help anyone reach or nearly reach their goal weight. So the meds are doing the heavy lifting for weight loss. And Holly and I love that. It's like, okay, we've said for years, losing weight's different than weight loss maintenance. So meds, losing weight, a winner. Now here comes the rub. We know number one, people aren't staying on them. When they go off them, they regain the weight. And we know even very little about people that stay on them long-term. Now, Renee, the medications don't promote physical activity. What's the role of physical activity? What can it do in weight loss versus how important is it in weight loss maintenance?

Renee Rogers:
It's such an important question. We did early on some work just talking with patients about this because that was what we were looking and thinking, of course, we know that what it takes sometimes to change our health behaviors, it's more than just having willpower in every aspect of what we do. It's really our environment, our context, our life. There's lots of things that shape that. And if we haven't had a previous healthy relationship with physical activity, if maybe it's been through the lens of burning calories, it's been always about changing our body weight. Just because there's now this medication that's helping on that front, it doesn't mean that the relationship with physical activity has been repaired or restored or that people are naturally going to see this new opportunity. So I love and appreciate having this conversation because movement is so key for so many metabolic processes in our body from a biological standpoint, but it can also help with our physical, mental well-being.

Renee Rogers:
At the end of the day, the piece that I think is most relevant to everyone, no matter where they're at on their weight loss journey, is just functioning your best every day. And while we losing weight from a mechanical perspective will help us function better, from that exercise lens, we understand that there's a line where that function and natural movement from unloading our body will occur. But at some point when it really comes down to that metabolic health. That deep underlying tissue health that we have, it takes that exercise, that overload and stress and contraction of our muscles to really make an impact.

Holly Wyatt:
So if people are losing weight without exercising, and we can talk about physical activity versus exercise, the words, let's not get hung up on the words, but without moving our bodies more, exercise, what are they missing out on? I mean, they can lose the weight. We know there's some people successful at getting the weight off, but what are they missing out on? And make sure they realize that, our listeners realize they're missing out on something.

Renee Rogers:
I think a lot of times when we lose weight, you know, we can talk about it from the number of the mass number on the scale. We can talk about it from a body composition, pure body composition perspective of, you know, the potential for losing muscle mass. Because anytime we lose weight, we are going to lose lean tissue, especially in a state of larger magnitude weight loss, similar to what we're seeing with GLP-1-based medications. Now, I will say we're actively doing research to understand how much is preservation, how much is not preservation.

Holly Wyatt:
Right, right.

Renee Rogers:
We stay slowly. This is like an interesting space, right, of debate during active weight loss. But the bigger piece of it is quality. And I like to think about quality over quantity is what are we actually doing to improve the health of what we have inside of our body and how that really is the piece of the puzzle that is when we talk about that word function is helping us to really live our best life to feel and function our best every day from an energy standpoint, from getting up and moving, walking up and down the stairs, being able to keep up with your kids and grandkids, that is really the big piece of the picture that exercise provides.

James Hill:
One of the things that Holly and I talk a lot about is we've been doing this for many, many years. And when people start out almost to a person, their goal is the number on the scale. That's their goal. But I think with these medications and people reaching or nearly reaching their goal, we have an opportunity to redefine what success looks like for them. It's not the number on the scale. That number on the scale doesn't make your spouse kinder. It doesn't make your boss treat you better. It doesn't make you necessarily enjoy life. And one of the worries we have is that some people take these medications, lose the weight, and don't work on necessarily eating right or physical activity. What can we do to help people understand it's not just weight?

Renee Rogers:
Yeah, it's a big question because it's hard because everybody's, you know, enters this conversation in a different place. And you all know, just with counseling and working with all the people that you've worked with over the years is that each individual conversation is always a little different. It's always a little bit unique and it's unfortunately our media, our culture has made exercise and even the dietary space so focused on the number on the scale and never has come back to what does this really mean for you and your confidence and your ability to live your best life. Also, you know, framing it around, we've seen the before and after pictures. We've seen the context of, you know, this idea, like you were saying, Jim, that it's going to fix something, right? And really, at the end of the day, when we reframe it around health and instead of this idea of the mass or the scale or the number, we are finding that people really are understanding that this is a continuous process where we're focused on our health and well-being and getting back to those keywords like function.

James Hill:
I want to follow up on one thing you said that a lot of people are interested in, which is the loss of muscle. Now, we've known for many years, anytime you lose weight, probably the majority is going to come from body fat, but some comes from fat-free, and part of that fat-free is muscle. I think what people are concerned about with the medications is you're losing proportionally more muscle than you would expect, but that's very controversial because you're losing so much weight. Now people are saying, well, maybe you end up with less muscle, but it's more functional, etc. What do you know about that and how are you guys approaching this?

Renee Rogers:
Yeah, I have these conversations all the time with our patients and our trials and in other spaces. And exactly what you said, Jim, I always remind them when you gain weight, you gain lean tissue to support your body frame. That's step one. So when you lose weight, it's natural to lose some of that lean tissue to, you know, we're reacclimating. We're going back to the baseline. You don't need all of it. So you're going to lose some, no matter what. Where that big question comes into play is how much should you lose? How much is okay? And what is that doing down to your metabolic health? And what happens if when you were to regain the weight? And it's tricky because I don't think we've done a wonderful job in really understanding how much the lean goes up, how much the lean goes down, what's to be expected, and then where's the gap. So now that we're in this new age, we're struggling to say what's okay and what's not in terms of the quantity that someone would lose. So when I hear words like preserve or people talking about the role of exercise and preserving, it makes my skin crawl just a little bit. I try not to get up on my researcher high horse soapbox about it, but I want to be honest with people and say, you should expect to lose some. We're actively doing that research now to understand, though, when you're specifically taking one of these contemporary GLP-1s that are out there, how much are you actually losing is a step one.

Renee Rogers:
And then step two, we're trying to understand with exercise training, does that help to slow that change in that quantity that's going down? So we have to look at both sides of it. We have to understand how much first, and then we have to look at what does exercise do in the relationship. And it's not just about measuring the body composition change or how much of its muscle, which we are doing, but we're also trying to understand the functional changes.

Holly Wyatt:
Right. It may be that if you have the same amount of muscle, but it's functioning different. It's kind of like bone. It's not just about how much bone you have. It's about the strength of the bone and whether it breaks or not when we look at DEXA. So I think when we look at bone in DEXA, I think we're kind of moving into that same idea about not all muscle may be equal. It may be different. But I love how you talk about kind of individualizing how people enter into this space and this relation and in different places in terms of their relationship with exercise nd you kind of have to meet them where they are.

Holly Wyatt:
When it comes to muscle, I think you're right on. And I think people need to be aware that there could be an issue because they're taking these meds. And so we, a part of that is to alert them that we don't know. But right now if they're on the meds, what could you do that would be the best to try if there is an issue that could try to help. We don't know for sure, but we don't have to wait five years, 10 years till we have all these studies. Let's do what we think might help. But I love how you're you're couching it.

Renee Rogers:
I think it's so it's so interesting and to think about all of it, because, you know, going through my behavioral lens, put physiology aside for a second, and I'm going to think about a human that's standing in front of me right now. The opportunity to get someone to do enough of something that's going to change their physiology only happens if you can get them to initiate in the first place. Right? If you can get them to find comfort or enjoyment or just confidence to be able to get started. So if we talk specifically about exercise in in this relationship, yeah, we can put you in a research study and we can ask you to do something and give you all the help and all the support and all the things and get you to do it. But in the real world we have to recognize that for a lot of people out there, that they maybe have not had a great previous experience with physical activity, or it's not felt good on their body, or they've been doing it just to burn calories, right? That's how they've always seen exercise in this relationship.

Renee Rogers:
Or at the end of the day, they've been told, you know what, you just need to start exercising and dieting and get this all under control, right? Which we all know from a biological standpoint, it's not as easy as we'd like to think it is. So there's a lot there for individual people that if we really need to stop necessarily talking about it sometimes from a numbers standpoint or what they should do or shouldn't do, and start with that initial conversation about movement, and what movement might mean for them. And just to pause and say if there's something that you haven't liked before, let's step back, maybe let go, and think of the next path that we can take. So if it is going outside and taking a walk. And that is something that we can help you connect with, that's a great place to start.

Renee Rogers:
If you're excited or interested in thinking about doing strength training now because you've only been told to do aerobic training to burn calories, then that's the opportunity we should find. But we've really got to take a big step back from telling people this is what you should do. We're seeing that on social media all the time, right? This is what you should do, or this is what's going to be the solution to let's meet in the middle. We want to get you to this point, but let's talk about the best starting point.

James Hill:
I think you're right. I think if you walk down the street and ask people if they should do more exercise, everybody would say, yeah, I should do more exercise. It's like, we know we should, but we're not. And again, I think we're good at these interventions to get people exercising for a short period of time, and then they lose interest and stop. And I think one of the things we know about exercise, it only works when you're doing it. It's like the meds. Once you stop it, you lose the benefit. Give me some optimism that we're going to be able to help people to understand this and start moving more. Where do you see the positives here?

Renee Rogers:
Enjoyment. We got to frame it around enjoyment. For many years, we talk about exercise as structured, right? And that's the true definition of exercise. It's structured, overloading the body, progressing the body. We use all these big terms that are very, I'm almost going to say harsh. They can be intimidating in and of themselves. We talk about how often you do it, the intensity you do it, how long you do it, and the type you should do. It's the fifth principle, F-I-T-T. But I love seeing now more and more exercise professionals and clinicians and other adding the E to the end of it, which is enjoyment. And if we step back and start talking to people about what they enjoy and asking the right questions, and even for people that are trying to find a healthy relationship with physical activity on their own, is stopping and asking yourself, what do you enjoy?

Renee Rogers:
And really going from there and thinking about it from that standpoint because you'll find when you dig deep enough, people will be like, I used to love going outside and we used to play kickball and get out and move our bodies that way. And you go, oh, have you ever tried that with your family or your kids? Well, that's not exercise. It may not be as structured, but it could be an entryway. And you're moving your body and you're doing positive things for your body. So maybe we're not hitting this high physiological metabolic stimulus, but if you haven't been moving and you go outside and start playing kickball, you've started moving and you've done something for your body. And then we find that enjoyment and that enjoyment gives people the opportunity to say, huh, I can do this. Wait, that felt really good. Oh, this doesn't hurt. Maybe I can do more.

Renee Rogers:
So we have to start with something that connects and is relevant to people, not feel like we should do it. And my favorite thing to think about is that for so long, we've done the shoulds, Jim, just like you said, we've done, we've shoulded a lot of people, right? You should do this versus, you know, exercise is actually supposed to serve us. We're not supposed to be a slave to it. And I think the flipping of that thinking is, how can the activity that I choose make me feel and function the best, both physically and mentally?

Holly Wyatt:
Yeah, we're believers in could. Opportunity, possibility. What could I do? What would feel good? Jim and I also talk about something we call the translational gap. And it's taking the efficacy of physical activity and how do you make it work in real world. So really to effectiveness. How do you take that? We know if you do this much physical activity in a study, it will work. But how do you make this part of your life? And enjoyment is one of the key things and jumping that gap and translating that gap and getting over there to where you will do it every day, not because you should, not even because it's going to make you healthy. I know doctors, as an MD, we love to think everybody's motivated by their health. And I've found some people are and some people aren't. And so figuring out whatever is going to motivate you, and it doesn't have to be your health. It may be connecting with your family in a way that you find enjoyable. But I think that enjoyment piece, we have not concentrated on that in terms of translating the science. And it's just as important as the efficacy, meaning does it work? So I love your idea of enjoyment. It's got to be front and center.

Renee Rogers:
I couldn't agree more. And I've experienced, too, with patients, and I'll say, like, you know, what is it that you enjoy? And they go, I don't know.

Holly Wyatt:
Yes.

Renee Rogers:
I don't know.

Holly Wyatt:
Yes.

Renee Rogers:
And that's okay. It's okay to not be sure about it. So I always like to say, okay, if you're not sure, I know that's maybe why you're here and why you're talking to me right now, but it still remains important. I'm not going to tell you what you should do. I love how you said could. I think that's a really great way to flip it. But one of the things that I'll flip around and ask the question is, so what are you worried about? Let's talk about that. Because if you've got worries or you've got lots of fears, I can help to combat some of those. But until you've had some experience, it's hard. It's hard to find that comfort level. So by understanding what you're worried about is really sometimes important because worry can overtake and paralyze us in terms of just taking that next step towards action. So if you're really worried about, for example, going to the gym and exercising in front of other people, well, that's a really important thing to say. That's okay. Don't go to the gym. Let's talk about other spaces where you can move and become active, that you're more comfortable. Because, again, at the end of the day, it's about getting you to move more. And I think it's such an important thing. So if you're worried about something or you have fears about something related to physical activity, that's okay. That's natural. There's a lot of people that have those fears. It's always great to reach out to somebody for help or try something in another direction. You don't need to be in a gym. You need to be in a space that you feel good.

James Hill:
Holly and I work a lot on weight loss maintenance, which is very different than weight loss. It involves different behaviors, different skills. And I couldn't agree more that the enjoyment is important. But we've just been talking about this recently, Renee, as people talk about how hard it is to maintain weight. And Holly has said over and over, if this is hard, you're not going to do it. She says, if you're hanging on by your fingernails, you have no hope of being successful. So we've been thinking a lot about how do you take maintenance being hard and make it easy? And I think the way you do this is a couple of ways. One is with habits and routines and rituals, because we've had the bad ones. Most of our behavior is automatic and it takes some time to develop these new habits, particularly around physical activity. And the other thing is your environment. And we talk about your physical environment, but also your social environment. If you're hanging out with people that never exercise, it's harder for you to do it. And so we think those habits, routines, and rituals and the environment are keys to taking these temporary behavior changes and making them permanent. Thoughts on that?

Renee Rogers:
It goes back to that individual person again, but I agree wholeheartedly. And I think that's one of the pieces of the really good behavior change strategy that comes into play is really understanding that you got to repeat things, You got to find that rhythm within your personal environment. And I think sometimes it starts with that exploration of what are those barriers around me? What are the things I'm worried about? What are the things that I enjoy? What is important to me from my family, my values? All those pieces. Understanding that first and then working in to build those consistent patterns and routines and pieces. Because you're right, we need to take some of the friction away. Some is undeniable. We can't change certain aspects of certain things. But if we do recognize where some of my good colleague, John Jakicic, also always says this, I have to give him credit, the orange construction barrels are, you know, we have detours all the time. But if we've got good patterns in place or good backup plans, we're going to get through that detour. We're going to make it to our destination, but we have to be prepared on how to navigate it. And I think that's where those routines and patterns can be really helpful.

Renee Rogers:
Specific to exercise and physical activity, those numbers for maintenance, for being physically active, we all know they're high, right? We're asking people to do a lot of physical activity to be up there. I think that's where we reframe it from the number to how are we living an active life.

James Hill:
It's also in how you frame it, too. I go back in the National Weight Control Registry, the average amount of physical activity was an hour a day. Oh, my God, an hour a day. Who can do that? Or you can say it only takes one hour out of 24 to do this. It's all in how you approach it. Is this a hard thing or is this, oh my gosh, I get this bang for just an hour? So that's where the mind is so important in all this.

Renee Rogers:
Oh, absolutely. And how you slice up that hour. No one ever said you had to do an hour all at one time, right? That 10-minute walk at lunch or 3 p.m. when you're fried at work and you get up and you take that 10-minute walk. Not only did you just help with your physical activity minutes and your physiology. Oh, you're now more alert. You're able to be more productive. Your mood has been elevated, right? So how we get to that 60 minutes is our opportunity. It goes back to, Jim, like you just said, our opportunity to have a better day to feel and function better throughout the day. So I love that thinking of how we splice it, how we talk about it. And unfortunately, sometimes when we're having a conversation with a clinician, they say, have you exercised? Have you gotten your minutes? It becomes that way. And so we tend to see it through that lens rather than what that opportunity really is to live an active life.

James Hill:
It's kind of sad in our society that we think that spending 4% of our day at physical activity is a lot.

Renee Rogers:
Yeah. It just does so much, too. It's so much to benefit us. But in a fast-paced world where everything comes quick, it's hard to think about delineating so much time. So splicing it up is smart.

James Hill:
But exercise is like the meds, they're both incredibly effective, but only if you do them. And when you stop them, you lose the effect.

Renee Rogers:
It is true. And it is. We hate to say you use it or you lose it, but when it comes to physiology and health and well-being, it's the same in any place, any health behavior across the board.

James Hill:
Exactly.

Holly Wyatt:
So I love your concepts. And this is what we talk about a lot is you've got to individualize it. That's why sometimes it's hard. People want one simple solution or to tell them the trick or the thing they need to do to be physically active or increase their exercise. And it needs to be individualized. It has to be because everybody's entering in a different place. Everybody has different motivation. Everybody has different fears, all the things you're talking about. And then the other word you use that we use a lot that I always talk about, let's explore. Let's try. We're going to try some things and you may not like them. We're going to try a dance class. And you may say that wasn't for me. And I'm going to say, great, but you've explored it. Now let's explore something else. And if you can make it fun and more like an exploration, not something I have to do or not something that is required of me, but something I get to try and figure out and be curious about. I think it really turns people around and gets them at least thinking about maybe this is possible for me. I just haven't quite uncovered what could work. So I want to ask one other question before we kind of get into some listener questions and some rapid fire. If someone's losing weight on a GLP-1, they're on a GLP-1, they've been successful, and they're maybe even approaching their goal weight, what would you want them to know?

Renee Rogers:
I think it's reminding them that goal weight is still something that once you get there, you got to keep working on other aspects to maintain it. To you guys' point in the work that you've done is it's a journey. There's not really necessarily an end point. And it's refocusing around that because, again, we've seen it with so many folks as they get there and they go, now what?

Holly Wyatt:
Yeah.

Renee Rogers:
Now, what do I do now? What's next? What's my new thing? And, or it was so fun during the weight loss. It was so liberating and empowering during the journey now that they've had this tool that really helps. And then they get down to that place and space and they go, okay, so now this is different. What does this look like? And I think we're still learning. I mean, even in the science and the clinical community, we're still helping patients learn and navigate because it is different for everybody. So it doesn't end with a goal weight. It really, an even bigger opportunity begins now that your body may feel and function better.

James Hill:
All right, Holly, you want to do some listener questions?

Holly Wyatt:
Let's do. I think it's that time.

James Hill:
All right, I'll start. Renee, here's one. If someone is losing weight on a GLP-1 medication, should they focus more on strength training or cardio?

Renee Rogers:
Wow, that's a good question. And I would love to tell you I have the perfect answer to that. I absolutely don't. We don't know yet, but it matters what your goal is. And let's go back to you. You as a human. So many patients have reported to us, especially when they start losing weight early on on a GLP-1-based medication, that they're fatigued. And with that being said, if you came to me, we would start to have a discussion about energy levels and helping you with that. And that would require more likely aerobic-based exercise. We'd want to work on your cardiovascular capacity so that you have more energy, you don't feel as fatigued. Now, if you came to me and we've had other patients say, “I'm feeling weaker. I'm noticing that now that I'm losing weight at the rate that I'm losing it that I'm feeling weak and I'm worried.” I would say, “Well, let's talk about the kinds of exercise that might help you feel stronger.” And that may lead you down a path of resistance training. So it goes back to Exercise Prescription 101 that every exercise professional out there is really good at is assessing and understanding what are you experiencing? And with that, how can we recommend the best exercise for you and what's important to you?

Holly Wyatt:
Follow up to that. When someone says I'm feeling fatigued, I hear that, too. Not everybody, but there's a group that says I do feel fatigued. What do you think is behind that? I'm always wondering, is it more nutritional? Should I be really focusing on diet? It sounds like you say, no, let's get some cardiovascular exercise going. Has that been successful for you?

Renee Rogers:
Yeah, you know, I do really feel that. And I think also when you dive a little deeper, a lot of folks and some of my data, my qualitative data originally is showing that for the people that are experiencing those things, they have the lowest levels of baseline physical activity as well. So we see an association or relationship between experiencing that fatigue and not making at least 150 minutes of moderate to vigorous physical activity a week. So these individuals have tended to be a bit more sedentary. At that point, maybe for numerous reasons, some have pain or other things that haven't been addressed. So sometimes we take a bigger step back and say, oh, let's talk about why you haven't been physically active. And if they're experiencing pain or something's wrong, I encourage them to, let's go see a physical therapist. Let's go see someone else and take care of that. But yes, it really seems to be that there hasn't been physical activity a part of their relationship yet. And we work on it from that standpoint.

Holly Wyatt:
That's great. I did not know about that relationship. So that is really some new stuff out there, the data you're collecting. Here's one that I do not know the answer. This is a listener question. I do not know the answer. So maybe we don't know it. Maybe you do. Does exercise impact appetite differently when on a GLP-1 medication? We've talked about appetite in general and how it's affected by physical activity. But is there something specific about being on a GLP-1 that's different maybe?

Renee Rogers:
Yeah, you know what? I would love to know the answer to this. In our studies where we're seeing folks coming in three days a week for activity, is just in general and just talking regularly with patients. I don't think so. We have that variability, you know, that for some people when they exercise, appetite goes up. For some people, appetite goes down. All those kinds of things. The GLP-1, I think that when a patient is at the right dose for them, they are in a place where exercise isn't really changing that. Now, even our folks that are on higher volumes of activity, meaning they're maybe on an aerobic machine for almost an hour or they're resistance training for almost an hour, I haven't seen any major changes, but I haven't collected that data directly either. So we want to be careful about assumptions. We do worry about patients not having enough fuel to do exercise, which is the other side of the equation with all of it, under eating and not having enough energy in the tank to get through exercise sessions. That's a totally other side of the coin.

Holly Wyatt:
Yeah.

James Hill:
All right. Here's one, Renee. Just timing of exercise matter?

Renee Rogers:
We haven't seen it directly. And if you're referring to morning versus night versus that kind of space and place, I will say that directly we haven't studied that with GLP-1-based medications. I will tell you that we've seen a lot of, especially for folks taking injections, we have a new space in place with our oral medications that are rapidly being FDA approved, but we haven't really looked at that. But we have noticed that depending on how someone experiences side effects related to their injection timing, that may matter in terms of when we would recommend an exercise session. So if someone notices that they're experiencing a little nausea the same day, we might avoid an intense exercise about that day and focus more on recovery, listening to their body and scheduling the exercise when it's a little bit better. So working to educate exercise professionals on those nuances as well right now.

Holly Wyatt:
Interesting. I've always thought of timing. Are you a morning or evening? Does it matter in terms of fat burning or the impact of the exercise? And now we're adding a whole new variable, the timing of your dose, oral or injectable may come into the timing of exercise. So a whole new thing to think about.

Renee Rogers:
That goes back to enjoyment. That biological nuance of being on a GLP-1 needs to be respected and understood, and people need to give themselves grace. You're not feeling good. You're experiencing some side effects on this day. You know that you, unfortunately, eat a little less on that injection day. It's maybe not the best day to exercise, and that's okay. Let's prioritize what feels best on our body so the next day we can and feel good about it, and it's okay. We're working towards doing it, not being shamed of it.

Holly Wyatt:
All right, Jim, should we move to the rapid fire? Those are my favorite. Or do you got another listener?

James Hill:
Go for it, Holly. Nope, do the rapid fire.

Holly Wyatt:
All right.

James Hill:
Let's see if Renee's up to the challenge.

Holly Wyatt:
I feel like she's going to be good at this. I just feel it. All right. If you could delete one exercise myth from the internet forever, what would it be?

Renee Rogers:
Exercise is going to help you lose weight on its own.

Holly Wyatt:
Yes, Jim, she's good at this. I can tell. All right. Someone says, I hate exercise. What's your first response?

Renee Rogers:
Please tell me more so I can help you.

Holly Wyatt:
Yes. What's one exercise rule people follow that you'd happily break?

Renee Rogers:
The expectation that every session they have to keep doing more. It's about showing up.

Holly Wyatt:
Yeah. If you only had 10 minutes, what would you do?

Renee Rogers:
I would go out for a walk.

James Hill:
Ooh.

Holly Wyatt:
What's the most overrated fitness trend right now?

Renee Rogers:
If you're not doing HIIT training, you're not getting anything out of it. High-intensity interval training.

Holly Wyatt:
Yeah. What's the most underrated fitness habit or trend?

Renee Rogers:
Walking.

Holly Wyatt:
Yeah. Love it. What's one thing people think matters but doesn't?

Renee Rogers:
That's so hard. I think protein, protein, protein without ever stimulating the muscle.

James Hill:
We've done podcasts on that one, so that's a good one.

Holly Wyatt:
She's really good at getting just that short answer.

James Hill:
People think protein is the total answer, but excess protein without a stimulus to do something with it isn't going to work.

Holly Wyatt:
Yeah. All right, here's a good one. Cardio first, strength first, or does it even matter?

Renee Rogers:
It depends on what you're training for. And we do have some data that shows that if you do cardio before you've strength trained, you could be… the muscle may be too warm. You may not get the same benefits. Honestly, though, let's step back. Unless you're powerlifting, doing extreme burst activity, it's a little bit too nuanced. I think what's going to be best for you in your workout. When we go to the gym, sometimes we got to get on the machine we can get on. So I wouldn't overstress.

Holly Wyatt:
Nice. Last one, what's your go-to advice for someone who keeps starting and stopping?

Renee Rogers:
It's never too late. We get that negative thought loop in our head that it's too late. It's been too many weeks. I'm too far gone. When the reality is we have so much data that shows that that quality, you can always improve what you have inside of your body. Don't be afraid to just start again by taking that walk.

Holly Wyatt:
And at any age. Any age. Even Jim's age.

James Hill:
It's good to know. Okay, Renee, now we're going to ask a couple of vulnerability questions. These are personal.

Renee Rogers:
All right.

James Hill:
And I'll start and then Holly can go. So what do you do when your motivation to exercise is low? How do you ramp that up personally?

Renee Rogers:
I'll give you my very vulnerable answer. I do not. I did not love exercise when I started in this field. Just don't. So I still have those negative thoughts of, I don't want to do this. I was a dancer. I loved moving my body. I did exercise science as my backup plan. I was like, exercise, dance, it's the same thing. You know, these are the same thing. So I think for me, when my motivation is low, I really try to step back and think about what is this going to do for me outside of that? Usually the thing that gets in my head is that I'm gonna sweat, I'm gonna maybe sore, I have to move a lot. Those deeper things and I really think about how it's gonna help me maybe clear my head or it's gonna make me in this moment function a little bit better, and is it gonna help me feel better in the next moment and I try to focus on those small things that are very personal. They're very personal because sometimes I feel after I've done it, I feel a little bit more empowered just to go on with the next thing in my day. So I try to hold on to that.

Holly Wyatt:
I love that. It's interesting. We go into fields sometimes for so many different reasons, but there was that interest there. And then I love that you say, you know what, I didn't love exercise, but you figured it out. And it sounds like that's something that we all struggle with. And so to hear you say that, I think that's helpful for our listeners.

James Hill:
Holly, you know the thing that really gets me going in those situations is how good it feels when you finish your workout. I feel morally superior after I've gone and done my workout. And I think I want to experience that. And I'm willing to go through what it takes to get to that moment.

Holly Wyatt:
Well, I'm glad that works for you, Jim. I have a lot of different tricks because I also don't really, haven't always been someone who exercised. I grew up thinking I was not an athlete, got a lot of messages that I was not a natural athlete. So I didn't really excel at sports and just kind of got in my head. I'm not one of those people. Had to work on getting that message out of my head and realizing I am an athlete just in different ways and all of that. So switch gears just a little bit because I love this question as a vulnerability question. What's something in your career that you thought you understood about exercise or you got wrong that's changed over time, that's evolved over time for you?

Renee Rogers:
Oh, yeah. You know, I came out of my exercise science program. I'm going to change the world, right? I was that person. I'm going to help all these people. And I started to get referrals. I worked in a medical fitness space initially and was working with a dietician, a clinical psychologist, myself. And providers were sending patients for weight loss. And I had this. I had this. I was going to help everybody. We were going to lose weight. Everything was going to be great. And I remember just feeling like the worst when someone would come to me and say like why are you making me do this

Renee Rogers:
Why are you making me do this. I'm not losing weight. And I thought I was someone originally was like well we got to increase your intensity. We gotta up your minutes. We gotta fix this. I didn't understand the biology of weight management and obesity treatment. And I was someone that made a mistake at some point probably telling someone to work harder. And that's hard. I went back and got better training and that's where I'm at today. So I'm very sensitive to conversations around you just got to do the work. You just got to work harder. The social media messages around every woman needs to get out there and strength train without really stopping and realizing the biological nuances of obesity is the disease and other things, right? Other things, metabolic conditions we may all be experiencing and having. We're still learning. And we need to really make sure that messaging around physical activity doesn't make people feel guilty because many people are really, really working hard already.

James Hill:
All right, Holly, it's time to sum up, and I'm going to make Renee do this by asking this question for our listeners. So I want you to respond to this hypothetical person, Renee. I've gone on the GLP-1 meds. I lost 30% of my weight. I'm incredibly happy. I don't have very many side effects. I'm going to take these forever. Why do I need to exercise? My health is better. My diabetes has gone away. My doctor loves my metabolic profile. Why do I need to exercise?

Renee Rogers:
Because I want you to continue to feel and function your best every day. And as we age, our bodies change, and we need to support our body in the best way possible. And physical activity hopefully will help you have as many wonderful opportunities to feel and function your best every day, support you on your life journey.

James Hill:
All right, Holly.

Holly Wyatt:
Great.

James Hill:
Renee, thank you. This has been incredible, and I think this information is going to be very, very useful to our listeners. You got to enjoy it. Look, you're not going to do anything long-term you don't enjoy it. And in this day and age, you can find a way to move your body that you like.

Holly Wyatt:
Yeah. And I love that this relationship with exercise is changing. So it changes as we change, but it's also really changing as the field is changing. So hopefully we can have you back and keep talking about this. I think it's an important topic our listeners really like to hear about.

James Hill:
Absolutely.

Renee Rogers:
Thank you all so much.

James Hill:
Thanks, Renee. And we'll see you next time on Weight Loss And.

Holly Wyatt:
Bye, everybody.

James Hill:
And that's a wrap for today's episode of Weight Loss And. We hope you enjoy diving into the world of weight loss with us.

Holly Wyatt:
If you want to stay connected and continue exploring the “Ands” of weight loss, be sure to follow our podcast on your favorite platform.

James Hill:
We'd also love to hear from you. Share your thoughts, questions, or topic suggestions by reaching out at weightlossand.com. Your feedback helps us tailor future episodes to your needs.

Holly Wyatt:
And remember, the journey doesn't end here. Keep applying the knowledge and strategies you've learned and embrace the power of the “And” in your own weight loss journey.