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Transcription of Interview with Yusef R. Battle, ACSM RCEP and Dr. Robert Huizenga
Transcription performed by
The Fit Solution intern Lauren Pitt
Major: Human Performance with a concentration in Sports Medicine
Minor: Chemistry at Howard University
Having worked with the participants of the Biggest Loser over several years, what would you consider to be the top ten practical behavior changes that are most effective for fat loss?
I think the number one most necessary thing is people have to recognize that there is a problem because; a lot of doctors, and certainly a lot of patients don’t realize that this is not a cosmetic issue. And they have to recognize that, in terms of the number of years lost off of health you got a lot of other big problems with cancers and motor vehicle accidents and even diseases like HIV where you have loss of life in the 4-5 hundred thousand range per month. And with obesity, depending on whose data you believe, you have anywhere between 10 thousand to 25 thousand people dying directly of obesity related diseases and you have another potentially 15 plus to minus from lack of fitness. So the first thing you have to do is recognize what that is. And then you have to do something. What we’re trying to do on the Biggest Loser is try to bring that down into a number or term that an individual can recognize rather than being told, “Gee if you smoke cigarettes if you’re overweight, if you are unfit, if you have a bad diet, if you use access alcohol, you are going to die early.” I think it’s very helpful if you can tell them how many years of life they’re taking off their individual life not some group number and number two sometimes we are even moving on to giving people a statistical update and that drives it home when they see the day based on their lifestyle their going to die versus the day they would be dying on average if they exhibited all of what we consider to be a healthy lifestyle and I think that’s the first thing…people have to recognize what the problem is. The second thing they have to do is be shown how to change because we know the number one recommendation of doctors and fitness people everywhere and the government is eat a little bit less, work out more and things are going to work out. And that is universally used on paper… and it’s a phenomenal recommendation and it never works! So that is something that has been cleared up over the past 20 years, working out more and eating a little bit less calories can again make great sense when you’re diagramming it on a piece of paper but it never works in real life. So we have to change things around. We have to come up with a way to incentivize people to work out more and make people want to work out more and there are a number of things to do there and likewise we have to make it easier for people and cheaper for people to eat healthy food instead of high sugar, high salt, high fat, high trans-fat foods and proteins that have high saturated fats and not as much omega-3’s. We know what we have to do, so I think the next big wave of research is to figure out how to make it functionally happen rather than telling people what to do, which we know doesn’t work. Now we have to find ways through probably 20 or 30 different routes all independently to make it happen. And look at the few areas in the country where we’ve had success and follow up on that. We are proud to say that The Biggest Loser, in terms of what we’ve done in the last 12 seasons of the show, we are one of the very few areas of the country that has not surgically shown substantial weight loss. Another instance is the Quakers, where obesity rates are very low despite relatively high fat foods. And that the kind of ‘go-for’ areas where we can see, we’ve made advances…rather than just saying “that’s impractical…or who in the world can work out 2 to three hours a day? Other that just saying that, and giving it lip service, let’s back up. Because we know that bariatric surgery has its own problems. So the other important thing that is obvious to do is increase motivation for these various healthy lifestyles. And as I already hinted, a part of that is giving people new and additional reasons to do it over and above looks. Let’s make sure we can convince them that they will feel better in the long run, IQ will go up and let’s give them some of the profit sharing. Let’s let everyone share in that savings when people make positive changes and get results and not just try, and make it happen. Because we know that, it seems like the difference between trying and really trying is worlds apart and we have now at least seen in the Biggest Loser not everybody wants to do something that aggressive, but when people say they will do it, essentially 100% of people can do it. Even if that is only 10 or 20 or 30% of the 160 million people that are obese or over fat in our country…that could be massive savings of lives!
Can you give us an example of some of the typical lifestyle patterns that some Biggest Loser individuals use when they went back home?
You have to be regular. You have to have a regular schedule that you can’t deviate from. Second thing is you have to have priorities. You have to put health and this whole package number one, so you have to have your regular exercise times and you have to prepare food in advance, and you can’t get caught without food every 4 hours because they you will be understandably highly likely to make a poor choice. You really have to plan your food out in the future. I know if you tell me what you are going to be doing next March…in March I can tell you exactly when I’m going to work out because it never changes. And that is the sort of adaptation that most of the successful people take. No one is saying it’s easy but dying isn’t that easy either or being sick and disabled. So people have to make a hard choice and when they understand what lies in front of them then that’s a huge incentive to spend this extra time and energy to get things done.
Now what did you see as some of the most common overarching obstacles and struggles that several participants had to overcome?
The number one overarching thing is life gets in the way. Some people have to earn a living. There are problems galore in their personal lives and there is always things to do to fill up the day and very frankly the high percentage of individuals that are overweight are depressed and mood changes definitely stand in the way and so that’s why certain psychological issues are one of my four cornerstones to the program. People need adequate sleep, and the other two are obviously diet and exercise. We try to move on all four of those pillars because if you have just two of them or even three sometimes that’s not enough. And this problem is so pervasive, so difficult, that if you don’t tackle all of them you are not going to do as good of a job. Problem is most doctors and health care professionals aren’t ready for the number or orthopedic injuries that are inevitably going to happen. We have to retrain doctors and physical therapist and exercise physiologist to anticipate and not get wigged out when they have overuse injuries. Everybody has to be very smart in knowing how to cross train and injuries should never be a reason to stop exercising, but also that is a huge bug-a-boo in these programs when people don’t have a sharp sports medicine team behind them.
How much exercise actually happens on average today on a person on the ranch?
On the ranch we usually give about 4 hours of exercise a day, which is about the same as what professional athletes do. Our program is based on what a human is reasonably able to do in intense exercise for that person. So we do it by what a professional athlete on a professional team would do. Also we have had about 80% success when people get down to 2- 2 ½ hours a day. We consider 2, 2 ½ hours a day for the general population for weight loss exercise.
Is that four hours of supported exercise?
The professionals work them out for about an hour and a half a day. The rest of the time they do all that exercise on their own.
What other types of support are these individuals getting on the ranch?
The individuals on the ranch have sports trainers, psychologist, dieticians, and motivating trainers. We also have sports doctors, so that’s the team.
What do you consider to be the most significant findings? (from the book)
The most significant finding is that people at home without the money for a trainer, without the money for a dietician, with no family, were able to lose about 25-30% of their weight, literally on their own with a support meeting about once a week on the phone. So we know there is a tremendous potential, with no monetary incentive. So we know there is a huge potential for massive weight loss out there, with the right team of individuals with a relatively meager follow-up, so it will just take some agency with the guts to do a very large study to collaborate this and I really think that is the wave of the future.
What fitness/nutrition myths do we have to pay special attention to?
Well I think the biggest myth is that with eating less and working out more you can lose weight. That is a giant myth. The other big myth is that you can deprive yourself dietary wise and you can keep that weight off whether it’s any diet, you name it. There has never been a diet in the history of man that has been shown to work at the two to five year mark. The third myth is that any of these weight loss products that you read about on the internet have any long term effects. And I know many. I have worked about 12 different weight loss shows… behind the scenes or in front of the scenes. I have seen a lot of health gurus and their products have been of little benefit.
What have you witnessed or consulted on as the best strategies to help communities lower their obesity rate?
It is a very long checklist that includes experts. It’s getting availability of workout places, it’s getting it so you can’t help but work out and can’t help but be exposed to healthy foods and you are incentivized to do the right thing. You have to roll all of these things together and try to match it up with our problem. You can’t expect people to lose weight, there has to be a huge system in place and even then it’s not going to be 100%, nor should we expect it to be….I think that there is a lot of excitement but it going to come down to someone really funding a study where we take hundreds of people in each arm.
What would you consider to be the best plan of attack to confront childhood obesity?
The first step of preventing childhood obesity is preventing women from gaining excessive weight during pregnancy. So we really have to start at the gynecologist office then we have to move to the home and we have to get communities involved to get these kids active because I think that for children it going to take a multi-pronged attack from pregnancy and moving on to make sure these kids hit their marks and do the things it would take; the increased activity and to teach moms how to prepare fruits in lieu of sweets and it’s got to be a massive education program. It’s do-able and will be cheaper than treating them then years down the road.
When growing up, were you interested in fitness and nutrition?
I played a lot of sports (three sports in high school and two or so sports in college. I played sports all through medical school). But you have to remember even in my era, even when I played sports in medical school, I was playing rugby when I went to Harvard Med School, I got hurt and got an AC separation, I was told by my counselor that I should stop exercising and concentrate on school like the other students and take school more seriously and not go out all weekend…and go out playing these wacky sports. So there is a very strong bent in the very top academic institutions about exercise up until probably very recently.
Was there someone there to influence you to do that?
I guess I was always interested in sports and it was kind of a back door to the whole thing because I was appointed the doctors for the Raiders when they happened to move to Los Angeles, through a series of quirks. And so when I took over as doctor for the Los Angeles Raiders, then I kind of backed into sports medicine because of the consequence of the job I had to go backwards and probably would not have done that if I did not luck into that job.
What are your current fitness and nutrition goals and how do you currently stay fit?
I have always wanted to stay the same weight since college. But that is usually based on working out 90 minutes a day. What I found it keeps me both mentally and physically on top of my game and that has seemed to pretty much work for me.
Why is fitness important to you?
For the psychological reasons…I feel better, two for the vanity reasons and number three for the health reasons.
What are your favorite healthy and not so healthy foods?
My favorite healthy food is fruit because I love having post workout fruit, Lactaid milk shake with some type of non-fat ricotta cheese. I am also a huge fish eater. I have to kind of fight away from the ice creams of the world and move into the sorbets and other things with that kind of cold taste.
What would be your favorite exercise?
Favorite exercise is definitely sport…whether it is being in a basketball or tennis league or being in a marathon, anything where there are a couple of other people you can go after.
In the region where you reside, what types of initiatives/programs and techniques are being used to help residence with physical activity and nutrition that stand out as innovative or groundbreaking?
None that I know of. The most groundbreaking thing people have done is to get soft drinks out of schools.
If you could give one statement for adults about exercise and nutrition, what would it be?
You have to make it a mandatory cognitive function. To get through school you have to have a certain basic grade and to get through school you should have a certain physical presence. (for kids). It’s also for adults. Adults have to have a certain confidence level to perform and they should have a certain fitness level…and then the side effect of that is they are healthier to boot.
Do you do anything now outside of TV to encourage people to stay healthy?
Right now I just got a call from a couple of senators in several different states to start working on some health laws, so I am reaching out to that.
What upcoming projects are you working on now in TV/Radio/Print?
A couple of shows including Second Chance Doctor, where we are going around helping people who aren’t getting the best in care. The second thing is we are currently looking at the exact long terms effects of what we are doing on Biggest Loser in a very hard scientific way, with researchers from all over the country including NIH. Thirdly, we are looking to try to expand what we are doing here to whole communities.
We talked previously about Exercise is Medicine (EIM) and helping physicians be better equipped to provide physical activity accountability and are working to add a one day physician and health provider obesity conference/symposium (as well as provide CME and CEC credits) to this year’s Healthier You-Fit Kids Health & Fitness Expo September 30th and October 1st
I’ve got about 4-5 different lectures on that. It’s just looking doctors in the eye and challenging them …get up and can you walk the walk. You’ve got to be able to lead an exercise class in order to give information. If you can’t, that’s fine, but then you really have to watch and get people that you trust. Because you can’t just refer people to any quote unquote trainer…their education levels are so shockingly disparate. You can’t just say go down to the local gym and find a trainer …because, as you know, training of those trainers is so shockingly variable.
Well I appreciate you giving me some time and I look forward to keeping in touch with you and making this happen in September and October.
Great seeing you and keep up the good work the reason I did this is because I think you are doing a he** of a job and you should be applauded for that.
Thank you very much. I appreciate that. I look forward to talking to you. I’ll call you and shoot you some emails along the way.
Yusef R.Battle, ACSM RCEP
The Fit Solution
Healthier You Fit Kids Initiative, Chair
www.FitSolution.org/fit.html
www.FitSolution.org
Yusef@FitSolution.org
240.994.5268 http://www.exerciseismedicine.org/ http://www.aahperd.org/letsmoveinschool/
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