As a board-certified obesity medicine physician, I’m often asked about the “secret” to sustainable weight loss. While there’s no magic bullet, one of the most underappreciated factors is something called NEAT—Non-Exercise Activity Thermogenesis. Simply put, NEAT is all the energy you burn through daily activities that aren’t formal exercise, sleeping, or eating. It’s the calories you expend taking the stairs, walking to your car, fidgeting at your desk, or even maintaining your posture throughout the day.
This is activity, not exercise—and that distinction matters.
When I practiced medicine in Europe at King’s College Hospital in London, I walked 10 minutes to the bus stop each morning, then another 10 minutes from the bus to the hospital. That was just my commute—I easily hit 10,000 steps daily without thinking about it. In the United States, my routine changed dramatically: I drove from my garage directly into the hospital parking garage. While I do accumulate steps walking through the hospital during my workday, the default American lifestyle makes reaching 10,000 steps much more challenging.
This isn’t a minor difference. Research on successful weight loss maintainers—people who lost significant weight and kept it off—has consistently found that daily walking, particularly achieving around 10,000 steps, is one of the key behaviors that distinguishes those who maintain their weight loss from those who regain it.
Understanding NEAT and Your Daily Energy Expenditure
Your body burns calories constantly, even at rest. In fact, basic physiological functions—breathing, maintaining body temperature, circulating blood, and cellular processes—account for a substantial portion of the roughly 2,000 calories most people need daily just to maintain their current weight. This is your basal metabolic rate. NEAT represents the variable component of your energy expenditure, and it can range from 200 to over 800 calories per day depending on your lifestyle choices.
This variability alone can mean the difference between struggling with obesity and maintaining a healthy weight.
The fundamental principle of weight loss remains straightforward: you must create a calorie deficit, meaning you burn more calories than you consume. While this sounds simple, achieving and maintaining this deficit is where most people struggle. NEAT offers a sustainable way to tip the energy balance in your favor without requiring gym memberships or structured workout programs.
The Science Behind Steps and Weight Loss
The evidence supporting daily step counts for weight loss is compelling. A large observational study of 26,935 people found that individuals in the “active” category (≥10,000 steps/day) had a 2.5 lbs greater decrease in weight compared to sedentary individuals (<5,000 steps/day) over 6 months.
Interestingly, the greatest incremental improvement occurred at 7,500-9,999 steps/day—what researchers call the “somewhat active” threshold. This suggests that if you’re currently sedentary, getting to 7,500-10,000 steps gives you the most significant return on investment.
For weight loss maintenance specifically, a secondary analysis from the Step-Up trial demonstrated that participants achieving ≥10% weight loss averaged approximately 9,822 total steps/day. This underscores what I see clinically: sustainable weight loss isn’t about sporadic intense exercise—it’s about consistent daily activity woven into your lifestyle.
Small Changes, Big Impact
The beauty of NEAT is that it accumulates through dozens of small decisions throughout your day—not formal exercise sessions:
- Taking the stairs instead of the elevator
- Parking farther from the store entrance
- Standing while talking on the phone
- Walking during lunch breaks
- Doing household chores at a brisk pace
- Fidgeting, shifting position, and maintaining active posture
None of these activities feel like “exercise,” yet collectively they can create a meaningful calorie deficit that, when sustained over weeks and months, inevitably leads to weight loss.
The 10,000 Steps Standard
I recommend that all my patients who are physically able invest in a pedometer, fitness tracker, or simply use their smartphone to count daily steps. Ten thousand steps should be the norm, not the exception. This isn’t an arbitrary number—it represents roughly 4-5 miles of walking and translates to approximately 300-500 calories burned, depending on your weight and walking pace.
When NEAT Alone Isn’t Enough
It’s important to acknowledge that weight loss becomes exceptionally challenging when chronic medical conditions are involved. Osteoarthritis can make movement painful, hypothyroidism slows your metabolism, diabetes creates insulin resistance that promotes fat storage, and numerous other conditions create physiological barriers to weight loss that willpower alone cannot overcome.
This is where comprehensive medical intervention becomes essential. At Synergy Medical in Lewisville, we combine board-certified obesity medicine expertise with evidence-based weight loss medications like Wegovy and Ozempic (GLP-1 therapies) to address the underlying metabolic dysfunction that makes weight loss so difficult. We don’t just tell you to “eat less and move more”—we provide medical solutions for medical problems.
Getting Started
Increasing your NEAT doesn’t require expensive equipment or a complete lifestyle overhaul. Start by:
- Getting a step counter – Your smartphone likely has one built-in, or invest in an inexpensive fitness tracker
- Setting a baseline – Track your current daily steps for a week without changing anything
- Gradually increasing – Add 1,000-2,000 steps per week until you reach 7,500-10,000
- Finding opportunities – Identify three places in your daily routine where you can add movement
Remember, sustainable weight loss isn’t about dramatic transformations—it’s about consistent, manageable changes that become permanent habits.
The Bottom Line
Increasing your NEAT is a proven strategy for creating the calorie deficit necessary for weight loss and, more importantly, for maintaining that loss long-term. It’s a NEAT way to change your life, and it’s not as expensive or complicated as you might think. Every step truly does count.
If you’re struggling with weight loss despite your best efforts, or if chronic medical conditions are making it nearly impossible to lose weight, schedule a consultation at Synergy Medical. Let’s work together to develop a comprehensive, medically-supervised plan that addresses your unique challenges and helps you achieve lasting results.
Dr. Essam – Board-Certified in Internal Medicine & Obesity Medicine
Synergy Weight Loss and Primary Care | Lewisville, Texas
Synergy Weight Loss and Primary Care is my answer to a healthcare system that too often prioritizes metrics over meaningful care—where patients become data points and diseases become diagnosis codes.