Dr. Sacks: Ninety minutes a week. Here’s the rationale. Exercise and weight loss has been very well researched and what the results say is that for losing weight, exercise has a very minor role. But for maintaining the weight that’s lost by nutrition, exercise has a very important role. So we wanted exercise primarily to kick in for weight maintenance. So our participants were mostly obese. They were not very well conditioned. They were not an exercising bunch of people. We had to start very slow and work up.

The purpose of the study was not exercise. It was to test different diets

Arthritis Today: That’s so interesting because people think you have to go to the gym and you have to kill yourself but it actually, at a certain point, becomes counterproductive to weight loss, doesn’t it, because it increases your appetite?

Dr. Sacks: That’s the problem. The studies have shown that people basically eat back some of the calories they burn off. So, the net calorie deficit from exercising is very small, but for producing weight loss, it just doesn’t cut it, but for maintaining weight loss, a small calorie deficit day after day after day is really quite relevant.

Arthritis Today: Have you ever tried to lose weight yourself?  

Dr. Sacks: Yes. Over time, my weight crept up. I had some knee problems and I couldn’t do my usual running. I just hadn’t worked out some alternative, and then in my work, I wound up traveling so much that gradually I gained weight. I gained 15 pounds, and after several years I said, well, I didn’t want to stay that way.

It really took a concerted effort. I lost 13 of those 15 over the last several years.

It’s not an easy thing. You’ve got to really think about what you’re eating and make some changes. Get rid of higher calorie foods in the house that aren’t that nutritious. You can use your imagination about that. Get rid of that stuff so it’s not there, if it’s not there, you’re not going to eat it. I had to take a look at when I was eating more than I needed to eat and what were the patterns and then how to change those. Eating huge meals out on the road when I had less control over it. Just being fed these buffets for breakfast to say, ‘Wait, what are you doing here?’ They are serving it, but I don’t have eat it.