Friday, December 10, 2010

Exercising When You’re Overweight

When you're overweight or obese, working out can be uncomfortable in more ways than one. Here's help. By Pamela Babcock, WebMD FeatureReviewed by Laura J. Martin, MD.

When you have a lot of weight to lose, it can be hard to work out. Not only is it physically uncomfortable, but there are often emotional challenges, too ---particularly if you feel too out of shape to go to a gym filled with buff bodies and wall-to-wall mirrors.

Amy Stevens has been there. The 38-year-old from Erwin, Tenn., has shed 151 pounds in the past year and a half, down from 368 pounds.


"Making exercise part of my life was a major challenge,” Stevens says. But she did it. Here’s advice -- from Stevens and health and fitness experts -- to help.

A Turning Point
Stevens had been overweight since high school but had an eye-opening experience while snorkeling in Barbados in May 2009. She couldn’t hoist herself up the ladder into the boat. Two men had to pull her back in.

“It took that kind of shock to the system to really get my attention,” Stevens says. She joined Weight Watchers online and now weighs 217 pounds - 49 pounds shy of her goal. Exercise has played a key role in her weight loss success. But, she admits, “It was absolutely terrifying to get started.”

Small Steps Pay Off
Stevens began walking a sixth of a mile around her neighborhood daily. “I was huffing and puffing at the end of it, but I just made myself do it,” she says.

Fearing the thought of walking into a co-ed gym, Stevens first turned to the women-only Curves fitness center franchise. The supportive atmosphere eased her fears. She stayed a year, working out three to five days a week.

In December 2009, Stevens read about The Couch-to-5K Running Plan on a weight loss message board and downloaded the program's podcast. She began running 60 seconds the first day. After nine weeks, she was able to run 30 minutes daily.

Stevens now works out at a wellness center near her job as director of marketing communications at Wellmont Health System, and has added strength training to her routine. She regularly runs 5Ks. Stevens admits she’s not “a very speedy runner. But I finish, and I’m proud of that.”

Danger: Emotional Hurdles Ahead
Stevens wasn’t alone in her fear of getting started. Mental barriers often hamper obese women’s efforts to get exercise, according to research presented at The Obesity Society’s annual meeting in October 2008.

Researchers at Temple University's Center for Obesity Research and Education studied data from 278 obese and normal-weight women. When it came to exercise, researchers found that the obese women were more likely to say they were self-conscious, afraid of injury, daunted by the effort, and to report minor aches and pains. And they were less likely to be exercising a year later.

Get Support
A key challenge is “getting started and feeling supported," says Gerald K. Endress, MS, fitness director of the Duke University Diet & Fitness Center in Durham, N.C. and an American College of Sports Medicine-registered clinical exercise physiologist.

Most obese people just don’t think they can do anything,” Endress says.
Endress recommends going to your doctor to make sure he or she understands what kind of exercise you’re planning to do.

Stevens did just that. Her doctor’s advice? “Just try. But if there’s pain, you’ve got to listen to your body,” she says.

To stay motivated, it often helps to work with a trainer who has experience with obese people or to go to a wellness center affiliated with a hospital that offers low-impact classes such as chair or water aerobics for special populations.

Endress also recommends recumbent exercise -- which is done lying down, such as a recumbent bike or recumbent stepper -- because it “supports the back and is easier on the knees and hip joints.”

Easy Does It
People should embark on a fitness program gradually because they may have underlying health issues such as high blood pressure, diabetes, or be prone to shortness of breath, dizziness, nausea, and overheating.

You can gradually work up to elliptical trainers. The key is to not sign up for a boot camp workout like on television’s The Biggest Loser because that may be too much, too soon.

"It’s best to get to the point where you can exercise 30 minutes comfortably three or four times a week before progressing to something more intense. It’s OK to break things up. If you can’t exercise 30 minutes at one time, aim for three 10-minute segments," Endress says.

Dos and Don'ts
Ready to get started? Endress recommends doing the following:

Get fitted with good shoes.
For instance, running store staff can analyze your gait and make recommendations.“The support makes all the difference,” Endress says.

Wear comfortable clothing.
Chafing is common in the leg and groin area. Shorts and a T-shirt are fine in the pool if you’re self-conscious or can’t find a suit.
Include strength training eventually. But to lose weight, focus on aerobic training in the beginning.
Consider a monitoring system to track weight, what you eat, and exercise. Many smart phones have applications or you can use online systems. Pedometers are helpful to get you moving.

But:
Don’t do high-impact exercise in the beginning. It’s fine to build up to, but jumping in with both feet landing on a hard surface “is usually going to hurt something,” Endress says.
Don't compare yourself to others in your class or gym or let feelings of self-consciousness overwhelm you. When people used to say, "Hey, you’re doing great!” Stevens says she often had the nagging thought, “If I were a thin person, they wouldn’t notice me.”
Don’t be impatient. Don't look for radical change in a short time or get fixated on big weight loss results like on The Biggest Loser. Although such shows can be motivating, they don’t help set realistic expectations. “You see people who lose two pounds in one week and they’re crying,” Endress says.

The key, Endress says, is to “be consistent and do something. There are too many people out there making excuses about why they can’t exercise.”

Stevens agrees. “It’s not easy," she says. " All of these things that you have to overcome with the fear of, 'Am I going to fit in?' and the self doubt."

"But it has absolutely been worth it," Stevens says. "It wasn't easy weighing 368 pounds."



Courtesy: WebMD.com newsletter

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