Ask the DOC

Ask the DOC

 As you are most likely aware, there is an epidemic of obesity in this country. There are no magic bullets to cure obesity. The two-pronged approach to lessen obesity is based on diet and exercise. Although exercise is probably less effective than diet in reducing weight, most experts agree that adding exercise to a diet program will increase weight loss. Exercise has additional benefits of lowering blood pressure, improving lipid levels, improving insulin sensitivity and lowering blood sugar.

Increasing energy expenditure by exercising can mobilize and burn fat, thereby reducing weight. Typically, without any change in caloric intake, 60 minutes of low intensity exercise most days of the week will remove about half a pound of fat per week. There are different kinds of exercise – aerobic (swimming, walking, bicycle riding), resistance (weight lifting), flexibility (stretching and yoga) and balance. Aerobic exercise is usually the foundation of an exercise program but the other types of exercise are important as well. For obese persons, light to moderate aerobic exercise is preferred and longer duration is also preferred (up to 60 minutes per day). Light-moderate exercise will raise the heart rate and induce sweating but the person should still be able to carry on a conversation. Beginners should start low and go slow in order to avoid dropout, muscle pains and aches and joint injury.

Progressive resistance exercises also promote favorable energy balance and weight loss but the key is to start with minimal amounts of weight. Gym newcomers should spend a few sessions with a personal trainer to become familiar with the equipment. Resistance exercise should be done on non-consecutive days to allow for muscle remodeling and to prevent excessive soreness. Yoga is the prototype of flexibility exercise and many find it helpful to join a yoga class. Balance exercise does not require equipment and can be static – balancing on one foot for at least 15 seconds – or dynamic – repeatedly standing up and sitting down without using hands for support. Balance exercise can include equipment like balance discs or wedges, wobble and rocker boards and Indo boards.

A comprehensive weight-loss program should include diet plus all four forms of exercise. The exercise part requires a time commitment, usually up to an hour a day (although initially it should be only about 10 minutes a day), but the benefits are multiple and include improved self-image. People do not become obese overnight. Likewise weight loss takes time if done in a healthy manner. SMART goals should be set – Specific, Measureable, Attainable, Realistic and Timely – in order to sustain the required self-discipline.

Always see your doctor before starting an exercise or weight loss program. Your doctor can help you design and plan both your diet and exercise regimen while ensuring that it will be safe as well as effective for you. Remember, you will be planning a strategy for staying healthy for many years to come.

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