True, False, or It's Complicated: The Weight Loss Myth-Busting Game

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:
Today, we're going to do something a little bit different. We're going to turn the podcast into a game.

James Hill:
Okay, I like games. I'm in. Let's do it.

Holly Wyatt:
So how we're going to do this, we're going to throw out statements that we hear all the time, things we hear in clinic, you know, patients say this statement or statements we hear on social media or statements maybe our colleagues say at some time when we're around them or just things we hear out in the real world. We're going to throw out a statement. You're going to play along with us while we do this.

James Hill:
So what's the game, Holly?

Holly Wyatt:
All right. So we give you a statement.

James Hill:
Yeah.

Holly Wyatt:
It's either going to be a true statement, a false statement, or it's complicated.

James Hill:
Oh, my God. Are all of them going to be complicated?

Holly Wyatt:
Well, we'll see. We'll see. That's the fun of it. So the thing I want the listener to do is when we first give out the statement, we're going to pause for a minute and let them think about what they would say, not just wait for us.

James Hill:
They can raise their hands if they think it's true or false.

Holly Wyatt:
Well, they can, but we can't see them. But I think they're not live here, Jim, but they can still play the game.

James Hill:
Okay. They can just play against themselves to see how many they...

Holly Wyatt:
And they can keep score. They could tell us, we beat you. We did better than... Because you're going to stay a statement and then I'm going to say whether I think it's true, false, or it's complicated. And then you're going to say what you think.

James Hill:
What if we disagree? Who's right?

Holly Wyatt:
Well, of course. Probably me, but we'll see.

Holly Wyatt:
The more important thing is after we talk about true, false, or it's complicated and why, we're going to talk a little bit about why it matters, like why understanding that statement matters or why it's complicated, but what that means for the listener, what they should know, that pie in the plate that we always talk about.

James Hill:
Okay. And the twist is we haven't seen each other's statements.

Holly Wyatt:
Exactly.

James Hill:
So mine are probably much better than yours, but we won't know until we get into it.

Holly Wyatt:
It's true. We can let the listener decide that. So this is real time, and some of them are going to be easy.

James Hill:
Some of them might not be so easy.

Holly Wyatt:
Yep, and that's where it's going to get interesting, because a lot of these may sound right. You've heard them a lot, but they don't always work the way people think.

James Hill:
All right, let's play, Holly.

Holly Wyatt:
Okay, so I will start. I will give a statement. Pause, Jim. You're going to want to just jump in. I know you. And then let the listener think about it for a second, and then you give me the answer, and we'll flip back and forth.

James Hill:
Okay.

Holly Wyatt:
I'm going to go first.

James Hill:
And my answers are true, false, complicated?

Holly Wyatt:
True, false, or it's complicated. You only have three choices.

James Hill:
Okay.

Holly Wyatt:
You ready? I'm ready. You look nervous. You a little nervous?

James Hill:
I can get through it. I'm okay. I'm good.

Holly Wyatt:
I know how you like to win.

James Hill:
I have coffee, so I'm good.

Holly Wyatt:
Okay. I know how you... I get nervous on games because I'm a big... I like to win. I mean, the game's a game.

James Hill:
I'll probably win, but we'll see.

Holly Wyatt:
Okay. We'll see. First statement. it. My metabolism is broken. True, false, or it's complicated. My metabolism is broken. What do you think, Jim?

James Hill:
It's complicated, Holly. What most people think when they think their metabolism is broken, they think their energy expenditure is low. They're not burning enough calories.

James Hill:
So the reason they gain weight is their energy requirements are low. In fact, people that are overweight or obese have higher energy requirements. So that part of metabolism isn't broken, but there is a part of metabolism that may be broken. Not for everybody. That's why it's complicated. So you and I talk about this in the book. Years of being sedentary, of being overweight, lead to what we call a sluggish or an inflexible metabolism. Now, you don't see this when you're measuring resting metabolic rate energy expenditure. What you see it is in response to challenges when you overeat or when you change your composition of your diet, if your metabolism is inflexible, you store a few more calories rather than burn them during these situations. So if I look at you in a steady state, I don't see anything wrong. But if I were to overfeed you or change your diet, that's when I might see people with an inflexible metabolism tend to store just a little bit more than people without it. Over time, this can be very, very important.

Holly Wyatt:
And when are we ever in a stable environment? We're always adjusting.

James Hill:
Only when researchers bring us in and measure us in an artificial situation.

Holly Wyatt:
Exactly. So people may say, oh, being out of a stable environment is rare. No, that's the more common.

James Hill:
Absolutely. And the way you fix it is physical activity. Diet can do some things. That's the way intermittent fasting or time-restricted eating may work because it kind of forces you to exercise your metabolism. But the real way you force your metabolism to be exercised is through physical activity. And that's why in our years, 40 plus years for me, a little less for you, although not too much less. You're getting up there.

James Hill:
But we rarely, rarely see anyone who's successful at long-term weight loss maintenance who doesn't find a way to make physical activity a part of their every day.

Holly Wyatt:
Yeah. This is important. Why it matters is if you think your metabolism is broken, doesn't it feel like I can't do anything about it?

James Hill:
Yes. And this you can. This, you can totally fix it. You can fix your metabolism through physical activity and maybe some diet things.

Holly Wyatt:
So you can make your metabolism work better.

James Hill:
Absolutely. You can make it as good as it can be, given your genetics. Everybody's different. Genetically, you're different. But what you can do is make your metabolism as good as it possibly can be.

Holly Wyatt:
Okay. So we agreed on that one. I said it's complicated, too.

James Hill:
And I was right. Okay.

Holly Wyatt:
And we were both right. And so next one, you get to go now.

James Hill:
Oh, I give you one?

Holly Wyatt:
Yeah.

James Hill:
All right, Holly. I'm going to give you an easy one to start with.

Holly Wyatt:
Okay.

James Hill:
Your body fights back when you lose weight.

Holly Wyatt:
Okay. Body fights back when you lose weight.

James Hill:
So think about that, listeners. Your body is working against you. You want to keep the weight off. Your body is sort of working to put the weight back on. Is that true or is that just a myth?

Holly Wyatt:
I think that is true. So it's not necessarily as much as people think, but I do think there are things that your body does to kind of push back in terms of as you lose weight, that energy expenditure goes down. Some of it's expected, may go down a little bit more than expected. We can talk about how important that is, but I do think that happens. I also think your appetite can come back and can increase and hunger hormones can get you thinking about food or desiring more food or wanting to eat more food. So I do think there are some physiological things that happen in your body. And, you know, fights back is an interesting way to put it. But some things that happen in your body once you lose weight that would push you toward eating more calories and thus gaining some of the weight back. What do you think?

James Hill:
Yeah, I told you I was gonna give you an easy one to start with. And I think that is easy. Very clearly, when you lose weight, your energy requirements go down. You need less energy to maintain your body. Also, the hormones that influence your food intake and appetite are ramped up. So you have a lower energy expenditure combined with a higher urge to eat. And that, you know, if you're not controlling things, that can lead to rapid weight regain.

Holly Wyatt:
So why it matters is to recognize that. So you know that's going to happen. That's just physiology. That's just the body. I do want to stress, though, it's not that you can't overcome it. I think sometimes people say that.

James Hill:
You can overcome it.

Holly Wyatt:
Right. Some people say that. It's like, so you give up. Don't do anything. Your body's going to push back.

James Hill:
No, no, no. Our whole book is on how you can succeed despite that. But understanding it is part of the battle toward addressing it.

Holly Wyatt:
Exactly. All right. You ready for another one, Jim?

James Hill:
Give me an easy one.

Holly Wyatt:
Oh, these are all easy. They should be all easy for you, Jim, at your stage in your career, as you're coming to an end of your career. All right. Number two, if I feel hungry, it means I should eat.

James Hill:
Ooh, that's a good one.

Holly Wyatt:
I feel hungry, it means I should eat. What do you think?

James Hill:
Holly, I'm going to give that one a big false.

Holly Wyatt:
False. Okay.

James Hill:
False. Because there are a lot of things that contribute to hunger. There are biological things, and then there are environmental things that... They're not a biological drive to eat, but they're a drive to eat. A great example is you have a great meal, you're full, and they bring out the dessert tray. Are you hungry? You have that desire to eat the dessert. It's not biological hunger. It may be environmental hunger. If you wanted to make it complicated, so it's the whole idea of hunger. What is it? Does hunger a biological thing, or is it a drive to eat? So you may have a drive to eat that isn't biological. It's cognitive based on the environment. Short answer is, if you think you're hungry, doesn't always mean you should eat. Sometimes, yes, but it's not true. So I'm going to say false and stick with it.

Holly Wyatt:
You said false. I said it's complicated, but I think we agree. It's not always that you need to eat. It might be. that you should eat. And we've talked about the GLP-1's kind of taken away, in some people, taking away the hunger signal completely. And it's there for a purpose. And sometimes being hungry means you should go out and eat some food. It's serving a purpose. And sometimes it's not. So whether it's false or complicated, I think that that's really probably kind of the same answer as what you said.

James Hill:
People eat for reasons other than a biological drive to eat. They eat when their body doesn't really need more energy. When your body needs more energy, you have signals to eat, but you also have signals to eat that don't mean your body needs more energy. How's that?

Holly Wyatt:
Perfect. And why it matters is, I think to think about, okay, I'm hungry. Why am I hungry? Sometimes a little bit of hunger isn't a bad thing either. You're in a negative energy balance if you're burning fat. And there may be a little bit of hunger. So to not just say, oh, I'm hungry, therefore I should eat. I know people who say, if I'm hungry, I'm going to eat. Not as straightforward as that. At least recognize what's really going on. A little bit of hunger could be okay. There may be times when you really do want to listen to your hunger. and there may be times when it's cravings or something else going on.

James Hill:
So I think this is important. We talk about the medications show that there's a whole biological component to weight. It's not all willpower, but there's a role for willpower. It's not that willpower doesn't play any role. And this may be one where a little bit of hunger is okay, doesn't take a lot of willpower not to eat, takes a little bit.

Holly Wyatt:
Right. Sometimes when you're hungry, you can actually do a little bit of a mindset and say that mind state shift, or that's what I think about. Okay, this means my fat burners have turned on.

James Hill:
That's right.

Holly Wyatt:
But if it's really strong and that might mean something else.

James Hill:
Yeah, exactly. Okay. Is it my turn?

Holly Wyatt:
It's your turn.

James Hill:
Let's do this one. Eating more protein helps with hunger and muscle during weight loss.

Holly Wyatt:
Oh.

James Hill:
And everything is protein. People are putting protein, companies are putting protein in everything, coffee, water, every food. Does it help?

Holly Wyatt:
See, you are giving me a tricky one. I'm going to say true, but I know what you're going to say to me. I already know what you're going to say. You're going to say, show me the studies, Holly. Show me the randomized controlled trials that prove this, da-da-da-da-da. Right now, if I was helping someone with weight loss, especially on the GLP-1s, I would want them to concentrate on their protein, and I do think that could help, or getting off the GLP-1s, help with hunger, and then, you know, help with the muscle. So I'm going to say true. With the caveat, I'm not sure we have all the data we need.

James Hill:
Okay, I'm going to agree with part of that. I do think it helps with hunger. And again, from everything we know, there's not much of a downside to increasing protein intake. If you take it too far, maybe. But really, if you eat more protein than your body needs, you basically get rid of it. So it's not a downside. People are looking at protein to prevent muscle loss with weight loss. I'm not sure protein alone will do it. Now, protein plus resistant exercise, I think, has the best chance of doing it. But I'm not sure that protein alone will really do a lot to save muscle. But again, it doesn't hurt. So looking for more protein is probably a pretty good strategy if you're on GLP-1 meds.

Holly Wyatt:
I would say the same thing right now. Until we have more data, I would probably say that's true. agreeing that you also need the stimulus, which is the exercise, to kind of save or to help preserve the muscle. All right. I got one for you, Jim. Are you ready?

James Hill:
I am ready.

Holly Wyatt:
GLP-1 medications fix the weight problem.

James Hill:
Ooh.

Holly Wyatt:
I'm getting tricky on you.

James Hill:
You are.

Holly Wyatt:
GLP-1 medications fix the weight problem.

James Hill:
All right, Holly, the answer to that is false.

Holly Wyatt:
Okay.

James Hill:
GLP-1 medications fix part of the weight problem. They are fabulous at producing weight loss. You and I have worked to produce weight loss for decades. We can't hold a torch to the GLP-1 meds. They are so much better than lifestyle for producing weight loss. However, the jury's out on the role of GLP-1 medications in weight loss maintenance.

James Hill:
And there are a couple of reasons for that. You and I have been very adamant over our career that weight loss is very different than weight loss maintenance. And when you go on the GLP-1 medications and lose weight, you're not going to lose weight forever. Thank goodness. You'd waste away to nothing. You're going to reach a point where your new energy requirements match your food intake. Now, that's a different ballgame. And I think we still have not figured out exactly how to produce weight loss maintenance. I think it's going to be a combination of medications and lifestyle. Some people will go on the meds, stay on them lifetime, and do fine. The data suggests that not many people are using that approach right now. That may change. Other people will go on the medications. They will then make lifestyle changes that allow them to maintain the weight without the medications. They may go through tough times and have to go back on the medication.

James Hill:
So I think we're going to mix and match medication and lifestyle for maintenance. But for weight loss, man, these medications are wonderful.

Holly Wyatt:
I said it's complicated, but...

James Hill:
Well, I made it simple. So there you go.

Holly Wyatt:
Oh, no, no, no. I said it's complicated, but I think you're right. It solves part of the problem. It fixes, in a sense, part of the problem, but not the whole problem. And I want to point out that it doesn't fix the problem for everybody.

James Hill:
No, that's the other thing is we're finding that some people don't lose weight on the meds. And then you get some people that have no side effects. We've had people on our podcast that say, ah, no side effects. Other people horrendous. It's like, no way am I going to live my life this way. It's not one size fits all.

Holly Wyatt:
So it's fixing part of the problem for a large number of people.

James Hill:
Yes.

Holly Wyatt:
But there's still people it's not fixing the problem for, and it's not fixing the whole problem. We haven't really, I agree, the weight loss maintenance thing is still really up in the air, and I'm not sure how that's going to turn out.

James Hill:
We need a lot more research, and we need a lot more real-life experience to see how we help people maintain. People are saying, well, low-dose medications. We're not sure that's actually going to work.

Holly Wyatt:
Right, right. And why people should care about this is if you go on these meds and you think it just fixes it, you need to understand what it can do. You need to understand that it doesn't fix the whole problem. That's why I think it's important to bring this statement up.

James Hill:
And when you stop the meds, everything goes away. The meds do not work if you don't take them.

Holly Wyatt:
So that's the other caveat. It doesn't really fix it. It just treats it in a sense or changes it as long as the medication is on board.

James Hill:
Absolutely. All right. Is it my turn?

Holly Wyatt:
It's your turn.

James Hill:
I'm going to stick with the food intake theme, Holly. Your environment affects how much you eat. True or false? Or complicated.

Holly Wyatt:
This one's easy.

James Hill:
That's easy.

Holly Wyatt:
This one's easy. Hopefully everybody got this. If they've been listening to the podcast, I think they got this. Your environment affects how much you eat. True. I'm confident. Yes.

James Hill:
All right. Explain.

Holly Wyatt:
So yes, physiology and hormones impact how much you eat. But I think we have good data to show that environment over time has really been what's increased our food intake, or why people have started to eat more calories and larger portions. And while I know that may be hard sometimes to look at, we are eating more. I feel confident that we're eating more. We're eating more calories. And I do think the environment is a reason. Portion size, how easy you can get to energy-dense foods, all those things impact how many calories we take in, which impacts our weight.

James Hill:
Yeah, I think we've got a lot of science to show that if you increase portion size (which we've done), if you increase energy density, you're going to eat more. And we've done that in our environment. So I agree. I think this one is easy. I wanted to give you an easy one so you get a victory.

Holly Wyatt:
I know. You're like that, Jim. But I want to ask you one question because as I was answering it, I thought, oh, Jim may come back with this. Sometimes when we look at surveys on how much food we've eaten or different changes in the food supply, we don't see these big changes as much. How would you push back against that?

James Hill:
Yeah. So one of the problems we've had, Holly, over the years is measuring how much food people are eating. It's one of the limitations in our field. We can actually begin to measure energy expenditure pretty well, even in real life. But we still rely on self-reports. We ask people what they eat, and we treat it as if it's true. We saw this back in the low-fat day. Everybody reported they ate less fat. A lot of the information suggests that they didn't. They just felt like they were trying to and told us that. And it's not as if people are lying. People, it's hard to remember what you eat. So I think that's part of the problem. And I don't think in the real world, we really have that good an indication of what people are actually eating.

Holly Wyatt:
I think that's important to realize because sometimes the studies come out and say, look, it doesn't look like food intake went up. I feel confident it did.

James Hill:
We did a study many years ago where we did, had dieticians, the experts, do food records, and they weren't very good at reporting their food intake. This is hard stuff.

Holly Wyatt:
And they knew how to do it.

James Hill:
They knew how to do it.

Holly Wyatt:
Yeah. Yeah. All right. So let's see. Whose turn is it?

James Hill:
Yours.

Holly Wyatt:
All right. I get to ask you one. All right. Wait, let me, oh, here's a good one. I just need more willpower to be successful. Just need more willpower to be successful.

James Hill:
Okay, think about that one.

Holly Wyatt:
You hear that all the time. Just get some more willpower and then you can do it.

James Hill:
Holly, that one is absolutely false. And we have not just years, we have decades of research showing that isn't true. Because we've done so many studies where we ask people to just use willpower to make lifestyle changes. And what we know is not everybody, but many people can do this over the short term. Almost no one can do it over the long term, which is why most people still today who lose weight aren't able to keep it off and they regain it. So you need some willpower, but you aren't going to succeed by willpower alone. And the new GLP-1 medications show that. Biology makes a huge difference. Role for willpower. Can't do it all with biology, but biology plays a huge role.

Holly Wyatt:
So I think in this, willpower alone will not get you there. I agree. A little bit of willpower perhaps is helpful, but the idea and people coming to me and saying, “I just need more willpower. I know it.” And I'm like, “No, that's not what you need.” And they'll even come to me and say, “I have willpower in other areas of my life. I'm very successful with this and I do this and I do this.” And I'm like, this is because when it comes to body weight regulation, food intake, you can't do it on willpower alone. You've got to be more strategic than just willpower. You've got to make it easy. The drugs have added a whole new toolbox for us to use. Willpower alone is not it. And why it matters, Jim, is don't just concentrate on willpower. I think we've brainwashed the society to think, I just need more willpower when that's not where they need to focus their attention.

James Hill:
Not just willpower, and it's not just biology.

Holly Wyatt:
Yeah.

James Hill:
Okay. I'm going to give you, this might be a controversial one. We'll see, Holly.

Holly Wyatt:
Okay.

James Hill:
You can out-exercise a bad diet. You can out-exercise a bad diet. True, false, or complicated?

Holly Wyatt:
I'm going to say false for the vast majority of people. Can I do that?

James Hill:
I'm going to say true. So this is good. You're going to say true? You can out-exercise a bad diet.

Holly Wyatt:
You can. You think you can. The majority of people. So that's why I'm...

James Hill:
No, no, no, no, no. I didn't say anything about the majority of people.

Holly Wyatt:
Oh, come on. We're not going to talk about the 5% out there.

James Hill:
Well, but here's the idea. Let me make my case and then you can make yours.

Holly Wyatt:
Okay.

James Hill:
So if you look at elite athletes, they're eating a lot of food and they're eating a lot of bad stuff. So I remember one study of the Tour de France cyclists, and they were eating, you know, way more sugar per day than anybody wanted because their thing was getting enough in. So yes, there are a few people, and actually they eat a fairly healthy diet, but they could eat crap and they still aren't going to gain weight. You're right. So there are a few people who can do it, and most people aren't there. But the whole idea is it's a balance. You can exercise enough so that you don't have to be careful on every single morsel you put in your mouth. The more you exercise, the more fun you can have with your diet and not gain weight. So it's possible, but I will give you that. For the majority of people, especially in today's environment, they're not going to do enough exercise that they don't have to pay attention to diet. But it is possible.

Holly Wyatt:
It is possible, but I think the majority of people, it's not. And a lot of people believe they can or do it that way. I'm going to go exercise, therefore I can eat whatever I want today.

James Hill:
We're talking about these elite athletes that do hours and hours per day. Most people, if they do 30 minutes, they feel like they've been active. That doesn't get it.

Holly Wyatt:
Yes, yes. And so that's what I was getting at. So in terms of why it matters is real. Don't have that mind state. Oh, if I do my exercise, then it doesn't matter what I eat.

James Hill:
But Holly, I would turn it around and say you can't overcome a sedentary lifestyle with a healthy diet. Again, I would say it's possible. A few people can do it. But most people, if they're sedentary, aren't going to be able to manage their weight through food.

Holly Wyatt:
Well, what about the GLP-1s now?

James Hill:
Well, GLP-1s have changed that. So now you're putting an artificial damper on this.

Holly Wyatt:
So it can work. A lot of people are doing that, Jim.

James Hill:
People are doing it with the GLP-1 medications. But the problem is, as soon as you release that break, which is the GLP-1 meds, boom, appetite comes back, you regain the weight.

Holly Wyatt:
And a lot of people are releasing the break. But there's a set of people who aren't releasing the break. They've been on the medication for five, six, seven years now.

James Hill:
And I want to see those people at 20 and 30 years. Because we're putting 12-year-olds on these medications who may be on them for 50 years.

Holly Wyatt:
True. I think that's the really interesting thing about the GLP-1s. It is allowing people to lose weight and maintain a low body weight without physical activity, which is new. That has not been what we've seen in the past.

James Hill:
It's new, and we will see long-term. And the short-term, I'm saying the short-term is three, four, or five years. It looks good. But we're talking about medications that are taken for life. So I think we'll learn a lot more as more and more people stay on these for longer periods of time. But I would say that the thing here is for most people to maintain a healthy weight, it takes both. It takes increasing physical activity and managing what you eat. And on the GLP-1 meds, it may be easier to maintain your weight, but I would say nutrition and physical activity are still important to optimize your experience with GLP-1 meds.

Holly Wyatt:
Okay. We're agreeing. It's kind of complicated, maybe.

James Hill:
Okay.

Holly Wyatt:
We had to talk about it a lot, Jim.

James Hill:
I'll accept that.

Holly Wyatt:
To get there, it's kind of complicated. I'll accept that.

James Hill:
We're not going to get through all these, Holly.

Holly Wyatt:
I know.

James Hill:
We never do.

Holly Wyatt:
I know. Let's do a couple more, though. I have one more. This is a good one because I hear this. These people come to me all the time. This is what they expect. This is what they want. This is what they say. Once I lose the weight, it should be easier to keep it off. Oh, I can tell you're thinking. I can tell this. I got a good one.

James Hill:
Listener, what do you think?

Holly Wyatt:
Once I lose the weight, it should be easier to keep it off. You've got to answer that one, Jim. It's going to you.

James Hill:
The answer is false.

Holly Wyatt:
False. Okay, let's hear. Let's hear about the false.

James Hill:
We're probably going to agree it's complicated, but my initial answer is it's false. And it's false because if it were easy to keep it off, we wouldn't have the extremely high rate of weight regain. Because the literature is filled with what our colleague Tom Wadden used to call V studies. Weight goes down and it comes back up. There aren't a lot of indications or a lot of research studies where people lost weight and they kept it off easily. Now, we've done the National Weight Control Registry where we have found a group of people that have done it, and we've learned a lot from them. But for the majority of people, it isn't easier to keep it off. It's different. I would say that. And one of the mistakes people make is thinking that what you do to lose weight is what you do to keep weight off. And if there's one thing we've learned, Holly, it's that weight loss maintenance is very different. So I would say that there are challenges in weight loss. There are different challenges in weight loss maintenance. But assuming that you're going to take the GLP-1 meds, you're going to lose weight, then you can stop the meds and everything's okay. That's a mistake you don't want to make.

Holly Wyatt:
I agree with that. I said it's complicated because... It's different, right? You got to think of it differently. And one of the things we always say is you've got to make it easier. Because weight loss is finite. You do it for a certain amount of time. You can't lose weight forever. It could be more difficult. You can do some difficult things for short periods of time. When it comes to weight loss maintenance, now we're in the forever your life. And it is different. And one of the things I think you have to do to be successful is make it easier. So that's sort of complicated. It's not easier, but you need to work on making it easier.

James Hill:
And Holly, the way you do that is with routines and habits and rituals, because most of our behavior is automatic. Most of our day, we do things that are just routines for us. I think the key to making maintenance easy is to get rid of all the routines that took you in the wrong direction and replace it with routines that take you in the right direction. If you can do that, then weight loss maintenance becomes automatic and it becomes easier.

Holly Wyatt:
So you want it to be easier and it's different. So you've got to put some things in place to make it easier. And I would add environment is the other thing in addition to the routines and rituals.

James Hill:
Social and physical.

Holly Wyatt:
Yes.

James Hill:
And again, we talk about this in the book, the importance of routines and the importance of the environment.

Holly Wyatt:
All right. You're going to give another one to me?

James Hill:
I'll give you another one. If the scale isn't going down, nothing is working. Weigh yourself. You're doing all these right things. The scale isn't moving, so it must not be working. True, false, or complicated?

Holly Wyatt:
I'm going to say false, but as always, it can be complicated. These were set up to be a little bit complicated. I'm going to say false because the scale isn't everything. So I'm going to say, what does working mean? And so we talk about success being bigger than just about the scale. And so I think that other things can be changing. So it can be working. And also the scale doesn't always show weight loss right away. There's other things that can get in the way to kind of mask the scale. So over time, if over six months, the scale doesn't move at all, then I would say it's not working if you are wanting to lose some weight. But short term, people do this too quickly. They'll say, oh, the scale hasn't moved this week. Therefore, it's not working. And we know that's not true. You can have lost some body fat and have some water weight shifts. And so I guess it's complicated would be maybe the better answer. It depends on the time course and it depends on what you mean by working. but I don't like people to just look at the scale and I want to make sure people give the scale long enough to really be able to use it as an evaluation tool.

James Hill:
And again, Holly, on the GLP-1 meds, people are going to reach a point where they quit losing weight and that doesn't mean the meds aren't working and I think a lot of people are saying, gosh, I stopped losing weight. The meds must have stopped working. They didn't. You've just reached a new equilibrium and the meds will keep you there but they may not produce more weight loss.

Holly Wyatt:
That's a great point. I didn't even think of it that way but that may be how what people are saying. They just think that if the scale isn't going down the medication has stopped working. Not true. I will say absolutely false on that one.

James Hill:
Okay. We got time for more?

Holly Wyatt:
]Yeah, let's do. I have a quick one but I do want to get it out there because I hear this all the time and I want to get your answer. I've got it written down. It's pretty easy but I want to hear what you say. It's, I need to cut carbs to lose weight.

James Hill:
I hear that a lot.

Holly Wyatt:
Oh, very common.

James Hill:
Carbs are the enemy.

Holly Wyatt:
I need to cut carbs to lose weight. That's a given. You got to do that. You got to cut some carbs to lose the weight. All right, Jim?

James Hill:
]False.

Holly Wyatt:
I agree on that one.

James Hill:
Carbs, you know, we go round and round. I remember when fat was the enemy. Now carbs are the enemy and protein is the hero. And we keep alternating these things. again at some level it is calories in and calories out now it's We can go beyond that. Types of calories matter in some conditions, but absolutely, and I think we have more and more data. We did, we were one of the first groups to compare weight loss with low-carb and low-fat diets, and we found in the long run there was no difference, and since then there have been a ton of studies, and I think we can put that to bed. If you want to lose weight, you can lose weight with any diet out there if you eat fewer calories. Now, during weight loss maintenance, it's a whole different ballgame. And we can look at the role of carbs there, but it depends on what else you eat. You cannot look at carbs without looking at what's the rest of the diet, what's your physical activity.

Holly Wyatt:
And how much you move, right? And maybe how much you sleep and how you live.

James Hill:
Absolutely. One of the problems with carbs is you fuel your physical activity with carbohydrates. That's your fuel for physical activity. If you're not doing physical activity, now carbs build up. You have more than you need. And yes, you can store so much, but you turn the rest eventually into fat. It's not the way the body likes to do it. But if you're not burning them, you got to do something with them. The answer is physical activity. And if you're physically active, carbs are your friend, not the enemy. If you're sedentary, yeah, carbs are a problem.

Holly Wyatt:
So I think the statement, I need to cut carbs to lose weight is false. You could. Cut carbs and lose weight. It's a potential possibility. Some people lose weight by cutting carbohydrates, but you don't have to. There's not one way. You don't need to. And I think when we hear that statement, a lot of people are like, that is the way to lose weight. You have to cut the carbs. And that's not true.

James Hill:
Okay, here's the last one. You ready?

Holly Wyatt:
Okay, make it a good one, Jim.

James Hill:
Okay. Consistency matters more than perfection.

Holly Wyatt:
Okay.

James Hill:
Think about that, listener. Consistency matters more than perfection. Is perfection our friend or enemy in this? What do you think, Holly?

Holly Wyatt:
True. I would go with consistency over perfection any day. And so many people out there think they have to be perfect. And when they're not perfect, what do they do? They throw up their hands and they're totally not consistent. They're perfect until they're not perfect, and then it goes all out the window. So consistency, especially in weight loss maintenance, I believe is the key. And there's data. National Weight Control Registry are pretty consistent across what they do in terms of weekdays and weekends and over different periods of time. So I would say that's definitely true. What do you think?

James Hill:
[38:15] Oh, I think it is definitely true. And again, you talked about occasionally you're going to get off plan. And that's okay. Get back on. Don't let it derail you because that's what we call in the book the victim mindset. If something happens, it's not my fault. I had a bad day at work. I'm going to go out and have the pizza and beer kind of thing. But you get back on track and you're consistent, not 100% of the time, but most of the time. If you're trying for perfection, you're probably going to fail because none of us can reach perfection.

Holly Wyatt:
And that just sets you up to be either completely perfect and on what you consider on plan or then completely off plan. And that just doesn't work. All right, Jim, I have one more because I want to end with this one. I think it's a good one to end with. If I could just find the one right plan for me, everything would work.

James Hill:
Wow, that's a good question. What do you think?

Holly Wyatt:
The one right plan. I just need to find it.

James Hill:
Holly, that is absolutely false.

Holly Wyatt:
I agree.

James Hill:
I think people have been looking for that. That's why the popular diets, a new one comes along and everybody says this may be the right one. You know, you can go to the bookstore and there are hundreds of diet plans. and you keep thinking, boy, this new one, I'm going to try it because it might work. I think one of the things that we've learned definitively is when it comes to weight management, one size does not fit all. We just talked about if you want to lose weight, you can do just about any diet to lose weight. You have lots of choices. And what we're trying to figure out is can we match person to diet? Can we figure out a diet that's mostly going to work for you? And that's mostly going to be a diet you can stick to. We know that if you stick to any of these diets, you're going to lose weight. So can we predict the diet that you're going to stick to? With weight loss maintenance, one of the ways that we talk about this in our book is there are many, many ways to keep weight off. You have to find something that works for you, which is why we presented our plan as a playbook.

James Hill:
And you, your job is to choose the plays that work for you. We can give you ideas. We can give you the science behind it. We can give you suggestions for plays, but you have to find ones that work for you. And you might look at something and we say, boy, this would work, but you're saying, no, I can't see doing that. Well, that's fine. Find ones that work for you. So do not look for that perfect plan that's going to make everything okay. You have to put together the pieces of these plans that fit for you. It is personalized weight management. And we're going to get better and better at helping people figure out what works for them, both during weight loss and weight loss maintenance. So false, Holly, false.

Holly Wyatt:
This is absolutely, people need to think about this because we just keep chasing something. We've been in this circular looking for the perfect diet, looking for the perfect plan, looking for the secret, so to speak. And we need to get away from that. So look for what's better for you, better for you, but it's not just one secret plan out there. The other thing I want to bring out is it can change over time.

James Hill:
Absolutely.

Holly Wyatt:
Yeah. So what's the best plan or a good plan for you now before you have kids might be different than after you have kids or when you go through menopause or when you start to retire.

James Hill:
Or you change a job or you move to a different part of the country. All these things can make a difference.

Holly Wyatt:
That's where you have to have that flexibility and looking for something that works for you, but not thinking there's just one way to do it. We need to let go of that.

James Hill:
Yes. Got to find something that works for you.

Holly Wyatt:
All right, Jim, this was fun. I like the game.

James Hill:
I think we should do this again, Holly. We can look at some other topics. I like this game.

Holly Wyatt:
Yeah, so the statement. So maybe we should have our listeners and my energizers and status slimmers who listen to this, send me statements that you want us to discuss and do the true, false, or it's complicated. And this is a way we can talk about a lot of things that maybe matter to you, things you wonder about.

James Hill:
That's what we want to hear. What are the things that matter to you? Because we'll have opinions on them.

Holly Wyatt:
We're not short on the opinion side. And I'm sure some of our colleagues might have disagreed with a few of ours. We might hear from them too. That's okay.

James Hill:
[43:16] We disagree with theirs too. So it works out.

Holly Wyatt:
All right. All right.

James Hill:
This has been fun. 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.