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The Quest to Lower BMI: Pay Attention to Performance, Not Calories
Wearable Tech World Feature Article
September 30, 2015
The Quest to Lower BMI: Pay Attention to Performance, Not Calories
By Kerri McMaster
co-founder and chief strategy officer, Performance Lab

More than half of Americans are having difficulty negotiating the see-saw of losing weight or maintaining their ideal weight. The nation’s hyper-tendency toward weight gain has made health insurers worried, and it’s easy to see why. According to the Centers for Disease Control and Prevention, in 2012 it cost $1400 more annually to treat an obese patient and $6,600 more for a diabetic, than a patient who had a healthy weight.

Insurers love to understand a constituent’s body mass index (BMI), or a measure of an individual’s body fat, because it serves as a key indicator of someone’s likelihood of developing certain chronic illnesses, such as diabetes, high blood pressure, and heart disease.

To keep people healthy, many insurers and employers reward employees who lower their BMI. We all know losing weight isn’t easy, but wearables may help keep folks on track by tracking fitness progress and allowing insurers to reward those making improvements to their health.

As the nation’s most popular form of exercise, walking has the potential to be part of the solution. But all too often it delivers no measurable gain.

The winning equation to lowering your BMI is one where calories out exceed calories in. To increase the “calories out” side of the equation, the body needs to be put under pressure some of the time, and often that includes a variation of the exercise routine. This requirement of variation and “stress,” reminds me of my neighbour who exercises by walking around the same block every day. He desperately wanted to lose weight, but constantly complained about not making progress. Yet, he didn’t walk faster, steered clear of the hills and didn’t even change the way he was eating, and when I last saw him he had gained weight. It was a hopeless merry-go-round! The lesson is that unchallenging exercise, however routinely accomplished, is simply not going to shift weight.

Building muscular strength and endurance has to be fed into a successful weight loss equation. The effect of increased muscle mass on calorie burn is real and long lasting, if often exaggerated. The additional benefit is the ability to perform activities with more resistance (such as hill work) that burn more calories.

By adding safe amounts of distance and resistance into a walk schedule – along with mandatory rest days – walkers fairly rapidly reach a magical milestone. Now we hit on the valuable BMI measure - time and again we find that dropping two points of BMI builds an almost <unshakeable faith> in the routine.


This is where a new generation of smarter wearables can come in. The wearable should prompt a user (before, after and during a workout) to comply with a routine tailored to that user’s ability, which also builds in the necessary variety and resistance training. By monitoring gradient, speed, stride rate, heart rate and other variables it is possible to automatically detect different training types such as hill and up tempo work, and offer trophies for compliance.

Automated prompts of this sort can be extremely effective. In a five year study conducted to build a business case to New Zealand’s largest health insurer, I set up 1,500 non-physically-active participants to receive automated behavioral prescription to guide them toward a goal of improving their fitness and completing a half marathon. Of the 1,500, 89 percent reached the start-line, with a 100 percent completion rate.

In my experience it is in fact better to focus on performance improvement rather than calories out when considering an exercise routine. Birthday cake, New Year’s champagne and game day hot dogs will happen, so there will always be times when excess calories makes weight go up. This can lead to feelings of failure and hopelessness. By contrast, focusing on an upward trend of fitness performance is sustainable, satisfying and part of a healthy lifestyle. It also makes the all-important resistance training feel fundamental – with smaller jeans as the welcome side effect.

Along with improving diet, focusing on fitness should be part of the arsenal of every individual and group seeking to lighten the load on their joints and the economy. And perhaps for the first time, wearables are in a strong position to help.          

Edited by Stefania Viscusi

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