Exercise and Weight Loss
… the good news!
Janet Huehls, MA, RCEP, CYT
Clinical Exercise Physiologist
UMass Memorial Weight Center
Janet.huehls@umassmemorial.org
774-441-6248
The Weight Center Exercise Program
• A benefit to you as a Weight Center patient
• Individual visit with a clinical exercise physiologist
▫ Call the Weight Center to schedule 774-443-3886
▫ Phone consults also available
• No extra fee, not required
• Our goal is to provide:
▫ Information
 From quality research
▫ Skills
 How to work around challenges
▫ Support
 Weekly email
 Ongoing visits before or after surgery
• The pictures in this
presentation are of
patients doing what they
enjoy after surgery.
• Keep in mind your OWN
goals.
• The sports and races are
not the goal.
• This is about YOUR true
goal for weight loss…
What
do you
REALLY
want from
weight
loss??
Myth #1:
“I am just not motivated”
• We ALL have motivation for
something!
• We have very good reasons
when we are avoiding certain
things
• The keys to exercise motivation:
▫ Keep it achievable
 Success breeds success
▫ Connect it with what you
REALLY want
▫ Create instant “results”
▫ Engineer your environment for
success (people, places, things)
Tapping into your true motivation…
“I completed my first ever
Warrior Dash.
I am nowhere near my goal, but
this was definitely an
accomplishment, I never
would have thought of doing
this before.
I truly believe, even though I am
not at my goal weight yet,
seeing this will help me get
there.
People need to know small
milestones are really
important.
Even though I didn’t “win” this
race, I am winner in my book
because I didn’t give up.”
Increasing Exercise Motivation
Outside Motivation
▫
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▫
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▫
▫
▫
▫
▫
The scale
Clothing size
Calories burned
Minutes exercised
Exercise partner
Exercise class
Winning a race
Competition
The weather
▫
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▫
▫
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•
Inside Motivation
Feeling better
More energy
Feeling of wellbeing
Sleeping better
Feeling stronger
Feeling calmer
Enjoying the challenge
Sense of
accomplishment
Lifestyle Activity
Move more every day!
Strength Training
2-3 days per week
8-15 repetitions
1-3 sets
To fatigue*
Gradually strive for
8,000-10,000+
steps per day
Consistency:
Cardiovascular
Meaning
Instant Gratification
Realistic
3-6 days per week
30-60 minutes
(or accumulate minutes)
Moderate intensity*
Stretching
After each bout of
physical activity
Mindful Stretching /
Yoga and
Relaxation
(*general guidelines- see exercise professional for individual recommendations)
Myth #2:
“Just moving more doesn’t count”
• “Sitting Disease”
▫ Too many “Energy
Savers”
▫ Greater risk of
heart disease,
diabetes, cancer…
• The average person
burns 700-800 fewer
calories per day than
in 1970
The Cure =Lifestyle Activity
 What?
◦ Moving more throughout day
◦ For the purpose of being more
physically active
 Why?
◦ Burns calories
◦ Easy way to gain benefits from
movement
◦ Feasible for those with pain issues
◦ Flexible and achievable
 How?
◦ Minutes of activity
◦ Use a pedometer
Pocket Pedometers & Activity Monitors
Steps to success, build the habit
1. Week 1:
▫ Track your steps every day for one week
▫ Find your average steps
2. Week 2:
▫ Set a goal to add 10% more steps
▫ i.e.: 3,000 steps a day average = goal of
3,300 steps each day
3. Continue to add 10% more steps each week by
adding small amounts of activity.
Tracking Steps
•Get baseline steps
•Wear pedometer all day every day and keep track of steps
•Notice where you could possibly add activity
Mon. Tues.
Wed.
Thurs.
Fri.
Sat.
Sun.
Steps
1852
2223
3832
1522
2255
3522
1232
Activity
Work
day
Work
day
Work and
shop
Meeting
all day
Work day
Yard work
Dinner
and movie
Comments
Could
have
walked
at lunch
Could
park
further at
work
Felt great!
Tired/
lazy
Knees
hurt
Average Steps per day = 2348
Goal next week = 2582 (10% more per day)
Tracking Steps
•Week 2: Increase by 5-10% from baseline average 2363 steps per day
•Goal: 2600 steps per day
Mon. Tues.
Wed.
Thurs.
Fri.
Sat.
Sun.
Steps
2752
2663
3700
1752
2622
2611
2633
Activity
Work
day
Work
day
Work and
shop
Meeting
all day
Work day
Took a
walk
before
dinner
Clean
house
Comments
10
minute
walk at
lunch
Parked at
further
from work
Felt lazy
Walked at
lunch
Felt great!
This week average = 2676 steps/ day!
How active are you in your vision?
“At a golf tournament with my family. One year ago,
I wouldn't have played, and I definitely wouldn't have
had my picture taken!”
Cardiovascular Exercise
•
•
•
•
•
•
•
•
• Continuous movement
Burns calories
• using as much muscle as
Improves health
possible
Increases stamina
• Walking, biking,
Lowers blood pressure &
swimming, dancing, etc.
blood sugar
• 30+ minutes
Lowers stress levels
▫ Accumulated if needed
Improves mood
• 3- 7 days per week
Improves sleep
• At a moderate pace
Etc.
Myth #3: I have to sweat to get a good workout
Myth #4: Exercise has to be hard
“Since my surgery, I have
done almost 20 races,
including a 1/2 marathon.
I have zip lined,
whitewater rafted, an 18
hour ocean kayak tour,
and went skydiving. All
these items on my bucket
list I never thought I
could do. It really is
possible!”
0 Nothing at all
1 Very light
2 Light
3 Moderate
4 Somewhat heavy
Rating of
Perceived
Exertion Scale
(RPE)
5 Heavy
6
7 Very heavy
8
9 Very, very heavy
10 Maximal
“Cardio” prepares you for surgery
• Helps with weight loss
▫ Especially losing the fat
around the organs in the
stomach
• Strength of heart and
lungs –
▫ Can lower the risks of
surgery and
▫ increase recovery rate
• Improves mood and
confidence – increasing
your ability to make other
lifestyle changes
“It was always hard for
me to get out and
walk/climb up mountain
terrains because of my
weight.
Now that I lost a little
over 100 pounds its a
lot easier.
I feel exhilarated when
I get out and
exercise”
“What if walking is painful
or too tiring?”
• Something is ALWAYS
better than nothing!
• Chair aerobics
▫ DVD’s
▫ Free YouTube videos
• Modify aerobics/kickboxing
DVDs
• Several short walks through
the day i.e.: three 10 minute
walks
• Floor pedal cycle
How much energy, stamina,
endurance will you need?
“My first mountain
climb 4,000ft! Almost
at my 1 year
anniversary! I have
some personal goals
still left but this is
one of my proudest!”
What do you want to lose?
Diet Only
Fat Muscle
Diet + Exercise “Normal” Aging
Fat Muscle
Fat Muscle
Myth #5:
I will get big bulky muscles
Muscle… Use it or Lose it
• Aging - After age 40, most
people lose about 1/3 lb. muscle
each year or 3-7 lbs per decade
• Menopause - as much as 1 lb.
lost per year!
• Dieting – The lower the
calories, the more muscle
lost
Myth #6:
“Muscle is bad for weight loss/ Muscle
weighs more than fat”
Daily
movement
makes a
difference
Basil Metabolic Rate (BMR)
Calories
burned
when in
active: 75%
has to do
with lean
body mass
(muscle)
Thermal Effect of Food (TEF)
All Physical Activity
Muscle Power!
The Benefits of Strength Training
• Metabolism▫ increases it by 15% or more!
▫ For 24+ hours after exercise
• Body comfort
• Blood sugar
• Bone strength
• Balance
• Low back health
• Injury prevention
• Sports performance
• “yes but…what about the
excess skin??”
Muscle, Strength & Quality of Life:
How much Quality of Life do you want?
Very low calorie diet
= greater loss of muscle
= less strength
= lower ability to
perform daily activities
• = lower quality of life
• !!!!!!!!!!!!!!!!!!!!!!!!!!!!
•
•
•
•
Strength Training
2-3 days per week
8-15 repetitions
1-3 sets
Free Weights,
machines, bands, etc
• Each major muscle
group
• To fatigue
•
•
•
•
• (*unless contraindicated)
How much strength do you need
for your vision?
“This is me shoveling snow
this winter. Not that I
enjoy shoveling - but at
103 lbs lighter, I sure
have no excuse to make
the kids do it now!”
Myth # 7
Stretching is not worth the time
Benefits of stretching
How to stretch
• “reset” muscles after
exercise
• Move joints easier
• Less muscle soreness
• Lower injury risk
• Relaxation
• Stress management
• More focus
• After any physical
activity
• To the point of mild
stretch, NOT pain
• Hold for 10-60 seconds
• Stretch all muscle
groups
• Breathe, pay attention
and relax while
stretching
How much flexibility will you need?
How relaxed do you want to feel?
“I started Bikram Yoga
before surgery and
returned at 6 weeks
post-op. I LOVE the
way it makes me
feel. I have made
so much progress in
my poses and I am so
excited to one day
compete in a yoga
competition!”
Keeping Exercise Safe
• Pay attention to symptoms
• Strive for consistency not
perfection
• Avoid sudden starts and stops
• Gradually add more activity
• Work at comfortable level
• Go easy on competition
• Take precautions in the
extreme heat
▫ DO NOT dress to increase
sweating.
• Stay hydrated
• Wear shoes designed for
exercise
“I completed the Bare
Hill Triathlon”
Exercise Before and After Surgery
Before Surgery
After Surgery
• Build the exercise habit
• Increase lifestyle activity
• Cardiovascular exercise three
days a week for 30 minutes
• Work around the challenges
that won’t change with weight
loss
▫ Family demands
▫ Work demands
▫ General motivation
• First six weeks
▫ Several short bouts of light
walking improves:
 Healing
 Digestion
 Energy
▫ Gradually increase as
energy increases to regular
cardiovascular exercise
• Six weeks and beyond
▫ STRENGTH TRAINING!
“The only person you
are DESTINED to
become is the person
you DECIDE to be”
Ralph Waldo Emerson
Exercise success:
• Consistent
• Balanced
• Realistic
• Energizing
• Meaningful