Strong Over Skinny: the Truth About Healthy Weight Maintenance & How to Achieve Your Ideal Balance
Just when we thought we had heard the last of this debate, the “strong versus skinny” paradigm is back at the forefront of our cultural attention. With the introduction of new weight loss medications and the aggressive marketing campaigns that are being used to push these products to any and all consumers, the messaging that we as women are receiving from the wellness universe now feels the same as it ever was: that to be truly healthy, we must always be thin. As a Master of Public Health, a Certified Health Education Specialist®, and a certified personal trainer please do allow me to blast a Coach Vera-sized hole through the false notion that thinness is the same as being and feeling your healthiest. I could end the article here- boom, it’s not focusing on being skinny, great news, the end! However, I wouldn’t be doing my job if I didn’t present you with the evidence that supports the fact that building muscle and focusing on making healthy additions will do more to keep you feeling and looking your best, for the long-term. So here go those pesky facts, please enjoy!
For those who don’t know how a personal trainer ended up with a graduate degree in public health, let me make my long origin story a bit shorter for you here: I started working as a personal trainer in 2011, where I quickly noticed that all of my clients were signing up with me and asking for the same things: they wanted to lose weight, look “toned” (AKA build muscle), and feel better in general. All of my clients were (and still are) women in their early forties to early sixties, who had a history of athletics or working out, who were struggling with newfound and stubborn fat in places on their bodies that they weren’t used to seeing. After programming a lot of basic nutrition plans to complement the workouts and seeing some great results for clients, I noticed that what I was giving my clients- and what they actually needed- was a holistic approach to their health. Sure, we did heart-pumping, sweat-inducing training sessions in the gym. But the changes really started happening when my clients began implementing the healthy habits (eating behaviors, stress reduction, stretching, abstaining from alcohol, etc.) that I was coaching them to practice outside of our work together in the gym. All of my clients thought they needed personal training, but what they actually were doing was shifting their entire lifestyles to support their health behaviors. After a few years of working with clients in the gym, I went back to grad school to earn my Masters of Public Health Promotion (MPH) so that I could make a bigger impact working with people to coach permanent lifestyle changes. Fast forward a few more years, and I have been in practice for over 12 years. I have been honored to work with clients in clinical settings from cancer treatment centers, to corporate healthcare providing weight management coaching, to the work I have done with hundreds of people who are looking to create real, lasting changes in their health and well-being.
My most recent corporate position had me consulting with patients who have been prescribed the glp-1 (which stands for glucagon-like peptide, and mimics that hormone in humans- creating the feeling of being full or satisfied after eating), sometimes referred to as semaglutides. Because of that work experience, I have a lot of specific knowledge about the claims that these drugs make and what patients who are taking them can expect to experience. Not only have I read the scientific literature on these drugs, I have had a chance to work with and coach patients who are actively taking these medications. Of course the first thing I want to outline here is that, as a practitioner, I am judgement free about all things- including whether or not people choose to take this class of drug. That is a personal decision, however I stop short of saying it is a decision that should be made by your doctor alone- these drugs are fairly new, and most general practitioners do not fully understand (nor is it their job!) how to support patients who are taking these medications. These drugs are NOT meant to be used without the supervision or support of a qualified professional- such as a certified health coach- and these drugs are not a quick fix.
My professional opinion is that these weight loss drugs are being prescribed too freely, to patients who could benefit more from making healthy lifestyle changes alone. There are a few problems with this line of marketing, however. Making “lifestyle changes” require thought, a bit of time (especially at first, as we learn new skills), and consistency- literally doing small things on a daily basis to care for our health. Not sexy, right? On the other hand, these weight loss drugs are being marketed as a fast, easy, and effective way to lose weight- and that that weight loss will be permanent. Super sexy! There’s no mention of making small but meaningful adjustments to nutrition, or making more time for being physically active, or cultivating a stress-reduction routine- nope, it’s one injection and you’re in the body of your dreams! That kind of marketing is dangerous because it sets a false premise: there is no one “quick fix” for everyone to live at their optimal level of health. The truth is that each of us is different, with unique habits, tastes, and preferences- sure there are some ground rules for health, like eating lean protein and lots of fruits and veggies and making sure we get some exercise each day, but outside of those general guidelines finding your ideal healthy routine takes a lot of experimentation.
Most people think that that sounds too difficult. Notice that I said most people think that that kind of trial-and-error will be too hard, however once we start that process for ourselves we find it invigorating! A lot of the talk around glp-1’s is that taking a pill or injection is just so much easier than doing all of that work- but that is perniciously misleading. ALL of the literature I have read regarding these drugs- that is, the scientific trials that were done to prove the efficacy of these meds- to a study, each one highly recommends taking the glp-1 in conjunction with a lifestyle coaching program or working with a qualified health coach to also work on proper nutrition and exercise. ALL OF THEM. So, in order to reap the most benefit from using these drugs you’re telling me I still need to adjust my eating and add more exercise? Yep. So the weight loss meds, while they’ll get you to the weight loss quicker, won’t actually help you lose more weight than diet and exercise alone. Oh, and before I forget- if you don’t prioritize protein intake and strength training specifically while taking these meds, you run the risk of losing lean muscle mass. Ladies, that means and increased risk of ostopenia and osteoperosis and sarcopenia- very serious conditions that will effect your health and independence as you age. So, to summarize: using glp-1’s in the absence of clinical support from a qualified coach will only produce weight loss through starvation. Starvation is antithetical to long-term health. What’s the solution? Normalize shifting your entire lifestyle.
Imagine marketing campaigns that sold us the idea that we ought to expect these kinds of changes to happen slowly, over time- and, by the way, behavior change science shows that small changes made slowly over time is the only way to make permanent changes. And normalize the ups and downs of this whole thing! We all know that once you get into a routine that works well for you, you can count on your life throwing you a curveball- so more adjustments, more learning, and more growing are going to be constant as a part of this lifelong process. What if, instead of dreading these behaviors, we just looked at them as a part of normal life? Imagine a commercial advertising the normalcy of eating lean protein at each meal, of showing folks making time for about 30 minutes of moderate exercise each day, an ad showing us all the fun we’re having when we’re not overdoing it with alcohol?
Spoiler alert: I am selling you something- I am selling you the idea that YOU ARE ALREADY ENOUGH. You don’t need another product, you don’t need another gadget- you are good to go! So, start going! Start doing those healthy behaviors that you know make you feel your best. Do those things today- do them right now, this article will still be here. Go. Get up. Go for that walk. Go grocery shopping and get your lean proteins and veggies for the week. Do those things today. Then do them again tomorrow. And again the next day. And again. (Wow, this is going to be a long commercial!)
Give yourself enough of a chance to try your health behaviors for long enough that they actually start to work. Most of us quit things right before they’re about to get easier, so remember that if your health journey is feeling tough right now you are probably just about to have a major breakthrough. If you need personal support, reach out to me and we can see how coaching could help you bridge the gap between your intentions and your actions. I am here for you! I love you.