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April 27, 2021
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‘Be inefficient’ mindset may help adults with obesity achieve healthy body weight

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Adults with obesity may have more success with weight loss by engaging in inefficient behaviors, according to a presenter at the Obesity Medicine Association 2021 virtual conference.

“Efficiency is a mindset that often facilitates professional success,” Harold Bays, MD, FOMA, medical director and president of the Louisville Metabolic and Atherosclerosis Research Center and chief science officer for the Obesity Medicine Association, told Healio. “Efficiency is also a mindset that may unfavorably promote onset and/or maintenance of overweight or obesity. A focus on efficiency may help explain why individuals who are successful in other aspects of their lives may find challenges in achieving and maintaining a healthful body weight. It may help if these individuals better understood that regarding body weight, it may be advantageous to transition from an efficiency mindset to an inefficiency mindset.”

Bays is the medical director and president of the Louisville Metabolic and Atherosclerosis Research Center and chief science officer for the Obesity Medicine Association.

There are several reasons highly motivated adults with overweight or obesity might struggle to achieve weight loss because of their efficiency mindset. One example is in food consumption. Energy dense ultra-processed foods may not require cooking and are often more efficient to obtain. Physical activity in which a person may hold on to treadmill handles or use some other assistance to make the exercise easier can also deter weight loss.

Bays said providers can help adults with overweight or obesity to learn to be more inefficient. Individuals can learn to be more inefficient in caloric absorption by consuming less energy-dense, high fiber foods with a lower glycemic load. Bays said a less efficient microbiota may impair or slow down intestinal nutrient absorption. When exercising, adults with overweight or obesity can be more inefficient by walking to a park rather than exercising in their home; they can avoid holding handles on a treadmill to be less efficient and expend more energy per time spent.

Other ways to be more inefficient and more healthful include parking farther away from a building, using the stairs instead of an elevator or escalator, and doing more shopping in a store instead of online. Adults with overweight or obesity should also be encouraged to take periodic breaks away from prolonged inactivity behind the computer screen — even if taking breaks is less efficient for work purposes — and move around even if they have a desk job.

Efficiency can also influence certain bodily functions. Some evidence exists that cooler surroundings result in an increased browning of fat cells, where mitochondria become less efficient in storing fat and burn more calories as heat.

“With obesity, one might imagine advantages if your mitochondria were inefficient,” Bays said. “In some animals, uncoupling proteins kick in during hibernation that cause mitochondria to be less efficient in storing fat and enhance non-shivering thermogenesis. However, you don’t want to be taking things such as 2,4-dinitrophenol, develop hyperthermia and increase risk of death.”

Adults trying to lose weight can also engage in skeletal muscle inefficiency by varying the type of physical exercise and resistance training. Routinely using the same muscle groups can sometimes cause them to be more efficient and result in less over time for the same movement. Varying the types of exercise may help mitigate biomechanical efficiency.

“In many ways, being less efficient is a key to achieve a healthy body weight,” Bays said. “For a lot of the patients we see, being efficient is an inherent or learned mindset that for many aspects of life, promotes success. But when it comes to achieving a healthy body weight, for some individuals, the message is the opposite. The message should be: ‘Be Inefficient.’”