Exercise and Weight Loss Observations as an Obesity Medicine Physician

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  • Exercise is often a “4 letter word”. The majority of my patients with overweight/obesity have had a previous bad or even traumatic experience with exercise. Many have been shamed in school PE classes. They have been injured by personal trainers insistent on the mantra of ”no pain, no gain”. They are uncomfortable wearing the clothing associated with exercise activities. They have an embedded and unrealistic idea of what the word “exercise” means. For these reasons I rarely use the word “exercise” in my clinic. However, we do talk a lot about about “activity”.
  • Activity? For my patients, I define activity as: “whatever you enjoy that gets you moving”. The responses have been varied: Can I walk, dance, garden, take my kids/grandkids to the park, lift weights,…? My answer is YES! You’re moving and enjoying the activity. Now, let’s make a realistic plan to increase your activity time and frequency.
  • The caveat to increasing activity is “please do no harm”. Choose an activity and start slow. Be safe! I do not want to learn that you ran a mile on day one and now your knees/hips/muscles hurt and you couldn’t walk for a day. In my experience, as patients lose weight, they note an increase in energy and confidence. They also notice a decrease in physical discomfort. The net result is an increase in their level of activity, enjoyment, and dedication. In short, as they increase activity they are rewarded and surprised by a generalized feeling of well-being!
  • Find a community. This may be simply asking a neighbor or friend to walk with you to keep you safe. However, the community will frequently find you! I often hear that neighborhood walkers, stair takers at work, yoga participants, etc. meet people with similar interests and goals while being active. The encouragement and support from your activity friends makes it more enjoyable, and you will keep each other motivated.
  • NEAT is an easy way to increase activity. NEAT is: Non-Exercise Activity Thermogenesis. It is the energy we expend that is movement NOT associated with purposeful moderate to vigorous exercise. This may include taking stairs, fidgeting, walking the “long way”, cleaning, shopping and so much more. NEAT has also been described as the activities that render us vibrant, unique and independent beings. So, move and let you be you!
  • Activity is critical to maintain your weight goal. Yay! You’ve reached your weight goal. I will be the first to celebrate with you, and I will also be the first to remind you that your activity needs to continue. However, by now it has become routine and enjoyable. The response I typically get is “Duh!” along with a wry smile. (This makes me happy!)
  • No excuses! This may sound a bit harsh. Be resilient! If you have bad knees, move your arms; bad shoulders, move your legs; don’t have time, stand up and pace whenever you are on the phone. You can find a way!
  • Beyond weight loss. Lastly, activity contributes to weight loss success. Additionally, the benefits include increased muscle mass, decreased blood pressure, improved sleep, decreased cancer risk, decreased dementia risk, and improved mood.
  • Summary: Be active! Start with what you enjoy, and then safely increase frequency and intensity. It’s not impossible and doesn’t need to be an unpleasant chore. It will benefit your weight loss journey, weight maintenance and so much more!

For more expert information on weight loss and activity, please visit me at scottsdaleweightloss.com. Thank you!

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