Ep #59: Comparing Weight Loss, Strength, and Health

You are listening to the Strong as a Working Mom podcast, Episode #59. Are you looking to lose weight, get strong, be healthy, or all of these? Let’s talk about what these mean and how to get them.

Welcome to the Strong as a Working Mom podcast. If you’re balancing career, family, wellness, and some days sanity, you are in the right place. This is where high-achieving, busy, working moms get the tools they need to eat, move, and think. I’m your host, physician, personal trainer, and Certified Life Coach, Carrie Holland. Let’s do this.

Hey, how are you? What’s new, what’s good? What’s good here, we are going to talk about the differences between weight loss, strength and health. I love talking about all three of these things. But I think it’s important to make some distinctions between them because weight loss, strength and health, they are not one in the same.

Here’s where this is coming from. In my coaching experience, not every one of my clients comes to me wanting to lose weight. Sure, many of them do, but losing weight is not always the primary goal. I imagine that’s the case for some of you. You may be at a weight at which you’re happy, but you may not have the strength to do the things you want to do.

Or maybe you’re at a certain weight, but you want to look muscular. Or you may have a certain amount of cardiovascular or muscular strength, but you don’t consider yourself healthy. There are a number of shades of gray in between all these. What I want to do today is break down each one of these for you, and help you get clear on the distinctions between weight loss, strength and health. Then you can decide which of these or which combination of these is most important to you, and you can focus your efforts appropriately. Because while there are most definitely some commonalities among these, there are some distinguishing characteristics and there are different things to consider in order to have each one of these. All right, let’s go.

First, let’s talk about weight loss. I’m going to take this concept and break it down even farther, because there are some important caveats to understand from the get go. That is the difference between weight loss and fat loss, they are different and I want you to understand how so. First, weight loss is very simply an overall decrease in your weight.

I think of weight loss as a broad term that essentially equates with a lower number. When you step on the scale, it’s a decrease in your overall body mass. But that loss in body mass can be from muscle, it can come from water, it can come from bone, or it can come from fat. The term weight loss doesn’t specify where that weight is coming from, it’s fairly nonspecific. When you step on the scale and see the number go down, you don’t really know what is responsible for that weight loss. As an example, for any of you who have followed a very low carb diet, or if you’ve tried keto, you probably know what I’m talking about. At the very beginning of a low carb diet, the initial weight loss you see is from water weight.

Remember that carbohydrates, they’re stored in your body as glycogen, and those glycogen stores get all wrapped up in water. So, when you adopt a low carb diet, and you start to break down and use up your glycogen stores for energy, you will diurese, or you will lose the water that was stored with it, and then you’ll see weight loss. But that weight loss is not the same as fat loss, that weight loss is due to water loss.

This also explains why the reverse is true. Meaning, if you follow a strict keto diet, and then you start introducing carbs again, you’ll see a fairly quick increase in your weight, because your body is replenishing its glycogen stores and it needs water to store those carbs. The weight you gain shortly after eating carbs, after a long period of not eating carbs, that isn’t fat gain, it’s water.

The same idea holds true for salt. When you have a salty meal, you will see it reflected in the scale the next day as an increased weight. And that’s because your body holds on to more water when you’ve taken in more salt. Your body likes to be in balance, that fancy medical term homeostasis, and your body likes a certain salt to water ratio. That means you’ll hang on to more water to balance out the increased salt load from your chips and salsa the night before, as example. But again, that’s not fat gain, that’s water weight.

Hormones will also impact water weight. You may notice that the week before your period, the scale goes up. And that’s most commonly due to water retention related to the hormonal fluctuations that are impacting your menstrual cycle. Hormonal birth control can also impact water weight shifts. Certain illnesses that impact your hormones, like Cushing syndrome or thyroid disease, can also impact water weight. I can go on here, but these are the most common factors that will impact your weight due to water retention; it is carbs, salt, and hormones. And I bring these up because while all of these will have an impact on the number you see on the scale, that number is going to be a reflection of water weight and not necessarily fat, and that’s important to understand.

Now, let’s talk about muscle loss and weight loss for just a minute. When you lose weight, it is likely that you will also lose muscle. I’ve said it before and it’s worth repeating here, but when you lose weight, you don’t get to control where that weight loss comes from. You don’t get to decide the proportion of weight loss that comes from fat or muscle. And it’s inevitable that when you do lose weight in the form of fat, you will also lose some muscle mass along with it. We don’t know for sure all the reasons behind this, but we do know that ethnicity and genetics may play a role, the total amount of weight you lose can play a role, and the rate at which you lose weight may play a role.

But all of this is still being ironed out by science. We still don’t understand all of the nuance behind the muscle loss that happens when you try to lose fat. But we do know that when you lose fat, you will also lose muscle along with it. And the other thing we do know about all this, is that the best way to prevent that muscle loss that happens when you lose fat is to start or continue strength training.

There it is yes, another reason to start strength training. If you want to mitigate the effects of the inevitable muscle loss that will happen when you lose fat, hit the weights. Lift heavy weight and build muscle, and be sure that you’re eating enough protein in order to support that muscle. Again, exactly how much protein you need to build and maintain muscle, that is hotly debated.

But I generally aim for at least 20% to 30% of your daily calories from protein. The ranges on this, in the literature, are anywhere from .5 to .7 grams per pound. Up to 1.5 grams of protein per pound or more. Lots and lots of argument over this, and I’m not here to settle that debate, at least not today anyway.

The point here is that if you want to increase your chances of hanging on to muscle as you lose fat, start or keep going with strength training, and aim for 20% to 30% of your daily calories from protein in order to support the muscle you’re working so hard to keep. To review so far, when we’re talking about weight loss, this is generally a broad term. The weight you lose can be from a number of sources. It can be water weight, muscle mass, or fat mass that you lose. On a side note, it can also be due to bone loss, as I mentioned earlier, and that would be true for people who have conditions like osteopenia or osteoporosis. But the most common sources of weight loss are due to losses from water, muscle or fat.

Okay, so now that we’ve talked about the broader concept of weight loss, let’s zone in specifically on fat loss because that is what most of you are interested in. Most of you, when you tell me that you want to lose weight, when we get into what that means what you’re really looking to do is lose fat. Fat loss means as you would expect, that you are losing weight by losing fat mass. That the number on the scale is going down largely from fat loss and less from water weight or muscle loss.

You do this by creating a calorie deficit. In order to lose fat, you will need to burn more calories than you take in. And the most effective way to do this is by creating a calorie deficit. Okay? There is no magic to this. I’ve said it before, I’ve yet to find a person successfully lose fat by eating more calories than she needed.

Until the science tells us otherwise, if you want to lose fat, you will need to adjust your diet in order to create a calorie deficit. I would love to say that is more complicated or complex than that, but right now, with what we know, we need to look at your calories and find a way to create a calorie deficit in order for you to achieve fat loss.

And honestly, more and more and more, I am encouraging you to look at food quality, and to do this quite often. If you look at your food quality, and make a few subtle shifts there, the payoff is dramatic. That means looking at the nutrient density of your food. It means looking at exactly what you’re eating. Too many people get the majority of their calories from calorie dense, nutrient poor foods.

In America, it’s known as the Standard American Diet, or the SAD diet, for a reason. The Standard American Diet is characterized by a high proportion of processed, and especially ultra-processed foods; refined carbs, added sugar, added fat, added salt, and little fiber. As I was preparing for this podcast, I came across research from NYU that found that Americans eat about 57% of their daily calories from ultra processed food.

Almost 60% of our daily calories comes from ultra processed food! That is mind blowing to me. And I share this because I’m guessing that if you were to take a close look at the foods you eat on a daily basis, and make some adjustments to the quality of your food, it would make a difference. If you traded one ultra processed snack in your day for an apple that would have an effect.

If you gave up one regular soda per day and had water instead, that would make a difference. It would create a calorie deficit. And again, to be clear, I’ve mentioned this before, when you’re looking to create a calorie deficit, it doesn’t automatically mean less food, right? It means less calories, and there’s a big difference. When you trade a burger and fries for a salad with chicken breast or tofu, you will likely be eating a larger volume of food but you’ll be taking in less calories. If you want to create a calorie deficit and lose fat, it means paying attention to what you’re eating. But then, it’s also looking at how much you’re eating. It’s no secret, portion sizes are growing and along with it, so are waist sizes.

Our super-sized society has unfortunately created a serious obesity problem. And one of the things you can do to reverse this is pay attention to your portions. This is especially true for calorie dense foods and hyper palatable ultra processed foods, like chips and cookies, where it is really, really easy to overdo it. It’s really easy to eat a lot more calories than you intended when you open up a bag of Cheetos and go back for fistfuls of more, right?

And then, one more thing with regard to fat loss because this comes up commonly, how do you know if you’re actually losing fat? This one, this is admittedly a bit of a challenge to answer. I mentioned earlier that the scale, while it is helpful in some ways, it really only tells you your weight. It doesn’t tell you your body composition. It doesn’t tell you how much of your weight is coming from water, muscle, fat or bone. You just get a number.

There are other ways to help measure fat loss, but I will be the first to admit that many of them are not slam dunks because they’re either inaccurate or impractical, or expensive. As an example, body fat scales are super popular right now, but they’re not super accurate. The literature on them so far has been less than promising. I wouldn’t rush to go and buy one of these scales just yet. There are also loads of other fancy scientific ways to measure fat loss that involve fancy equipment and devices that are found in physiology labs. But they’re not readily available and they’re impractical. And for our purposes, the most useful way to track fat loss is with a DEXA scan, which uses X-rays to estimate your percent body fat.

But again, DEXA scans are not easy to access outside a doctor’s office. If you want to stay out of your doctor’s office and a science lab, other ways to estimate fat loss include taking measurements with a tape measure of certain areas like your abdomen, waist, hips, etc. Again, that’s not super accurate. And then last, one other option that I’ve used to measure fat, is to use calipers to measure fat in certain areas on your body by pinching that fat and measuring it that way. If you’ve never done this before, I would suggest having someone who’s been trained and knows how to do it help you. Plus, it can be hard to accurately calibrate yourself; I’m speaking from experience here.

You’re seeing a common theme here, and that’s that it’s hard to accurately measure fat loss. I bring this all up to point out that the scale, while useful, does not tell the whole story. To summarize, weight loss is a broad term that simply means the number on the scale is going down. Fat loss, on the other hand, means the loss of fat, which is what most people are looking for, and what most people are referring to when they want to lose weight.

Fat loss happens when you create a consistent calorie deficit and burn more calories than you take in. That can often happen by adjusting the quality, and of course, the quantity of your food. All right? Next, let’s talk about strength. If you have the goal of getting stronger, awesome. I’ve had people reach out and ask me how they can get stronger. But often, I have to clarify what they mean by that. Because strength means different things, depending on who you ask. Let me explain.

Strength, in and of itself, simply means your ability to exert force. It’s your ability to complete physical tasks using your own body. It’s your power. In weightlifting terms, it’s your ability to pick up heavy things. Just kidding, but you get the idea. For some of you, the strength may go beyond simply how much you can bench press at the gym. For some of you, when you say strength, you mean cardiovascular strength. Being able to walk or run, keep up with your kids without getting winded, walking upstairs without losing your breath, or finishing a race like a 5k or triathlon.

All of these are examples of strength, and it all counts; walking, running, aqua jogging, weightlifting, all of it. All of these activities count, and they all contribute to your strength. But here’s the important distinction I want to make, and this is in relation specifically to strength training. I may have a client reach out to me and she’ll tell me she wants to get stronger; awesome, game on.

We come up with a plan for her to start strength training, or go to a CrossFit class, and she’ll start lifting weights. She’ll notice that she’s feeling stronger, but she’s not looking stronger. And she’ll tell me, “I don’t see any muscle.” That’s the distinction to make here. There is a big difference between being strong and looking muscular. Okay? A big, big difference. And I want you to understand this so when you’re setting your fitness goals you can take this into consideration. Let’s break this down a little more.

Again, I’m going specifically to weightlifting here. We use the terms “building muscle” “strength training” and “weightlifting” interchangeably, but there’s a key difference. I want you to understand weightlifting as a general term, it’s the umbrella term. It means, essentially, that you pick up heavy stuff, you put it down and you repeat. I know I’m getting a little cheeky here but honestly, that’s what weightlifting is; pick up heavy stuff, put it down and repeat. I like to keep things simple.

But within weightlifting, there is strength training versus hypertrophy training; they are not the same. But again, to keep this simple, it boils down to strength versus size. Let’s start with strength training. As it sounds, strength training has the ultimate goal of making your muscles stronger. On a practical level, this means being able to lift more weight. It’s going from doing bicep curls with 12-pound dumbbells, to biceps curls with 15-pound dumbbells. And you can do this because with practice, your muscles get stronger, and you’re building strength.

This, in general, will come from doing a weightlifting program that involves four to six sets of a low number of reps, four to six, with a good amount of rest; three to five minutes. And so, this is where you’re lifting heavy. You’re not necessarily going to failure, but you’re doing multiple sets of a few reps, and you are going hard. You have to give yourself enough rest so that you can come back and do each of those sets with solid form. Okay? That was strength training.

Now contrast that to hypertrophy training. When I think of hypertrophy, I think of size. We were talking about strength training just a second ago, that’s making your muscles stronger. And now, we’re talking about hypertrophy training, that’s making your muscles bigger. You do that, in general, with an increased training volume than you would do for strength training.

That means doing an increased number of reps with shorter rest periods. But you’re lifting less heavy weight than you would if you’re doing straight up strength training. Okay, so that would look like three to five sets of 10 reps with 60 seconds’ rest. The goal here is to increase the size of your muscles. So, now I’m getting nerdy, and if your head is spinning at all, just know this, when you strength train, there’s lifting to get strong, and there’s lifting to get big. And there’s overlap to these. Often, when you build strength, you build size, and vice versa. But I wanted to talk about these because they are two different styles or approaches to lifting weights, and I want you to know what you’re looking for when you tell me, “I want to start weightlifting.” A solid strength training program will have different phases of each of these worked in. There may be a strength phase, and there may be a hypertrophy phase, and each with different goals.

Alright, so now that we’ve talked about the difference between lifting for strength versus lifting for size, let me also add this. There is a difference between being strong and looking muscular. Okay? This is really, really important. And I want to talk about this, because I’ve run into it a number of times, and I want to help you get really clear on what your goal is. It is one thing to be strong. It is one thing to be able to put up a lot of weight at the gym and grab the 45-pound plates, or the 50-pound dumbbells, and be strong. Okay? It is another thing altogether to look muscular. And this is where this comes up. You may go through the work of changing up your lifestyle and losing weight and losing fat, but then you tell me that you don’t look fit or you don’t look strong.

But what I find most often, is what you’re really asking is why you don’t see muscle. It’s the skinny-fat dilemma. And the answer to this is lifting weights. If you want to see muscle, you have to lift weights. And I’m not talking about a once-a-week random Instagram HIIT workout, okay? I’m talking about a structured program designed for progressive overload that results in building muscle.

That will come from alternating phases of strength training with hypertrophy training. It’s one thing to lose weight, but it’s another thing entirely to look muscular. And if you want to look muscular, you have to hit the weights hard. The other side of this coin is this. Say you start a dedicated weight training program that’s designed for progressive overload. You may be hitting the weights and getting stronger. And you have evidence for this because you’re able to lift heavier weights when you go to the gym to do your workouts. But then you’ll ask why you’re not seeing muscle, and it will come back to your diet. It’s both, in order to look muscular. It’s both diet and weight training.

Lifting weights is what will help you build muscle. And then, in order to see that muscle, you have to eat in a way that supports it. That means eating an appropriate amount of calories. If you’re overweight, you’ll need to eat in a calorie deficit to drive fat loss. I think of it this way, weight training builds muscle, and your diet is what will help you lose the fat that is covering the muscles you’re working so hard for in the first place. Okay?

That may be oversimplifying, but again, I really like simple. And you will want to ensure that you’re eating enough protein in order to drive muscle growth, repair and recovery. That is the other piece to this. Whether you are overweight or not, if you want to look muscular, you’ll need to lift weights, but then you need to eat in a way that supports muscle growth and strength. That means getting in adequate protein. I mentioned it earlier, so I won’t go crazy on it again here, but that typically means at least 0.7 grams per pound of body weight, but ideally, more. You need the protein from your diet to help build and repair muscle so that it comes back both bigger and stronger after your weight training sessions, okay?

To summarize, strength is your ability to do tasks and perform work with your own body. For our purposes today, we’re talking about both cardiovascular and muscular strength. Both are important for overall health. There is a difference between being strong and looking muscular. Both involve challenging yourself by lifting weights. But looking muscular often requires a change to your diet, in order to lose the fat that is covering the muscles you’re working to build. And whether you’re looking to lose weight or not, in order to look muscular, I would encourage you to look at your protein intake and ensure that you’re getting at least 0.7 grams of protein per pound daily.

All right, last, but certainly not least, let’s talk about health. The definition of health has evolved over time. It used to be that health, at the most basic level, was thought of as the absence of illness or disease. But it is so much more than that. And it’s a little weird of me to define one thing by the absence of something else. Over time, things have changed. The WHO, or the World Health Organization, defines health as a state of complete physical, mental and social well being, and not just the absence of disease. I just gave you the fancy accepted definition from a very large, very well recognized organization. I love that it’s all encompassing.

Health is not simply avoiding disease; yes, that matters. Being in good physical health and having a body that functions properly and allows you to do the things you want to do, that matters. But what also matters, is having good mental health and avoiding or managing conditions like anxiety, depression, or social relationships, also matter. In a side note, if you haven’t seen or heard about it, there was a book recently published, and it’s called The Good Life: Lessons from the World’s Longest Scientific Study of Happiness. This book was written by two Harvard professors, who carried out a decades long, multi-generational study on what makes a good, long, healthy life.

One of the key factors is having quality relationships. Humans, we are a social species, and having solid relationships is important. If you haven’t read the book, check it out. It was really interesting. But the takeaway here is that the term “health” and being healthy is all inclusive. Being healthy includes your physical, mental, and social wellbeing. Notice that nowhere in here is there anything about your weight. And that’s just it, we went through what weight loss, fat loss, strength, having muscle and health all mean. And now that we’ve done that, I want to zone in on the intersection of health, weight loss and strength. Or to make it even more broad, let’s take strength and replace it with fitness.

Let’s talk about where health, fitness and weight loss all collide. We’re learning more and more that when it comes to better health, and we’re talking both quality and quantity of life, that fitness matters more than weight loss, okay? This is huge. This is important. On a very basic level, if you’re going to prioritize one over the other, prioritize fitness over weight loss. More and more good scientific literature, and I mean, high-quality, large, well-designed studies, when I say good. More good studies are suggesting that overweight and obese people will improve their health more by gaining fitness than by losing weight.

In fact, there was a recent large review article that concluded that people who start exercising can improve their overall health, even if their weight doesn’t change. They can improve their overall health and decrease the risk of dying, even if their weight doesn’t change. That is amazing to me. Studies even suggest that obese people who improve their fitness have more longevity than someone at a “normal” weight, but who is not physically fit. This is huge and really important to understand. To boil this down and make it as simple as possible, exercise will do more for your overall health than losing weight will, okay?

The crazy thing is, we don’t even know why this is. We don’t yet know why exercise has this impact on your health, even in the absence of weight loss. It’s thought that exercise may be promoting some fancy cellular processes in your fat that ultimately affect your insulin resistance. But science has yet to iron out the exact details. I’m hoping that in the coming years we’ll understand this more, but it is just so cool.

For right now, the key takeaway here is that if you want to improve your overall health, prioritize exercise. Prioritize movement and fitness over losing weight. This is just another reason to uncouple exercise from weight loss. Okay? I see it all the time, and I’ll repeat it here, exercise on the whole will do very little to help you lose weight. That’s largely because exercise is a very, very small component of the total amount of energy you expend in a day. And when you take into account the increased hunger that results from increasing your exercise, the impact of exercise on losing weight is most often negligible. Again, one more time, do not use exercise to lose weight. Okay? It is a losing battle. There’s evidence that supports exercise to maintain weight loss once you’ve lost it. But exercise for the sole purposes of weight loss is a losing game.

So, instead, use exercise to feel good, and use exercise to improve your health. Because if you’re looking to live longer and live healthier, it’s exercise that will help you, not necessarily losing weight. Okay? I cannot stress how essential it is to understand this. Alright, so the last thing I want to make super clear here, is that when we’re talking about weight loss, strength and health, they are all different. And having one does not mean having the others. As an example, losing weight or losing fat does not equate with health. There are many people who have lost weight while eating a largely processed food diet and I would not call them healthy, by any means.

I’m sure you can probably think of someone you know who’s nearly starved themselves and used all kinds of fad diets in order to lose weight, only to regain it all back and then some. And to me, that does not equal health. Weight loss and fat loss do not equal health. This is especially true for yo-yo dieting. In fact, when all other factors are equal, people who yo-yo diet tend to have worse health outcomes than people who maintain a weight that is above what’s considered normal.

All of this is to say, that weight loss, in and of itself, does not give you health. And in the same light, weight loss also does not give you strength, it simply gives you a smaller body. It does not mean that that smaller body is more muscular, and it doesn’t mean that smaller body has increased strength. Again, think of the skinny-fat people you know. Thin does not equal strong, not at all. Okay?

In order to be strong, in order to have physical fitness, you have to move your body. You have to use your body to do work. And that work can take the form of cardiovascular exercise, strength training, or preferably both. If you’re going to choose one, please choose strong over skinny, okay? We went over this. But if you’re going to prioritize something, prioritize movement and obtaining fitness over a number on the scale.

And then last, being strong and being healthy are two different things. When I think of strong, I think of having the physical capacity to do the things you want to do. Like, run or walk or bike or swim or lift weights or even carry a heavy box of groceries in from your Costco. Run or go for a walk with your kids around the neighborhood without getting winded. Strong means your body is able to produce the work you need it to. And again, to review, as I said earlier, being strong and looking muscular are two very different things. While neither being strong nor having muscle equates with health, we are seeing more and more that exercise is an important component of your health. Exercise most definitely makes you stronger.

But exercise also contributes to your overall health and longevity. It can decrease your risk of chronic disease. It’s good for your mood and your mental health. It can breed social connection; I can go on here. But the point is that while there’s a growing link between strength and health, they are not one and the same.

Last but not least, if I haven’t made it clear yet, let me shout it from the rooftops. Your weight does not tell the whole story. Having a “normal” weight does not give you either strength or health. Your weight is a number; nothing more, nothing less. That number tells me nothing about your physical health. It tells me nothing about your mental health. It tells me nothing about your strength. It tells me nothing about your fitness.

It is a number, and you can certainly pursue a number. If there is a weight at which you would like to live, please go for it. I’m not at all trying to deter you from pursuing weight loss, if that’s important to you. I help loads of women do exactly that. I also understand that living at a lower weight might help you have an easier time pursuing strength or staying healthy. They are all interconnected. But please know, simply getting to your goal weight doesn’t mean you’re done. The lower number on the scale doesn’t give you a longer, fuller life. That number doesn’t give you strength. It doesn’t give you health. Your weight is one small piece of a much larger puzzle. Okay?

So, now that I’ve shared all this and have broken down the differences and gotten into the nuance of weight loss, strength and health, you get to decide what matters most to you. Where do you want to focus your efforts? How satisfied are you with your weight, your strength and your overall health? And how does that impact the decisions you make about how you eat and move? I’ll be the first to admit these are big questions for sure. But if you’ve decided that you need to change your lifestyle, I want you to know why. Why are you choosing to do it? What is your goal? Is it weight loss? Is it to get stronger? Is it to be healthy? Or all of the above? You get to choose. But I want you to be very clear that weight loss, strength and health, they’re not the same. Okay? And if you need help pursuing any one of these, let’s talk.

When you coach with me, I will help you decide what matters most to you, whether that’s losing weight, gaining strength, getting healthier or all of these. And once you decide, we create a plan to get you there. Check out my website, and go to www.CarrieHollandMD.com/contact. Tell me about your goals and let’s get started.

All right. Thank you again for hanging out with me, and I’ll catch you again next week.

If you like what you’ve been hearing, please review the show. I would love to get your feedback and ideas. Your suggestions have inspired episodes and will help me make the show better for you. And share this podcast with a friend, text a show link, share a screenshot, or post a link to the show on your social media. Be sure to tag me @CarrieHollandMD on either Instagram or Facebook, so I can follow along and engage with you.

This is how we get the word out to other working moms who want to feel strong, inside and out. If you know someone who wants to feel better or eat and move differently but she is too tired or too busy, it is time to change things up. And you know, making that change starts with how you think. And that is what we do here on the Strong as a Working Mom podcast. I’ll see you next week.

Thanks for listening to Strong as a Working Mom. If you want more information on how to eat, move, and think, so you can live in the body you want, with the mind to match, visit me at CarrieHollandMD.com.