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Exercise and Weight Loss… the good news!Janet Huehls, MA, RCEP, CYT
Clinical Exercise Physiologist UMass Memorial Weight [email protected]
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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
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•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…
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What do you REALLY want from weight loss??
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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)
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Tapping into your true motivation…
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“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.”
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Outside Motivation ▫The scale▫Clothing size▫Calories burned▫Minutes exercised▫Exercise partner▫Exercise class▫Winning a race▫Competition▫The weather
Inside Motivation▫Feeling better▫More energy▫Feeling of wellbeing▫Sleeping better▫Feeling stronger▫Feeling calmer▫Enjoying the
challenge▫Sense of
accomplishment•
Increasing Exercise Motivation
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Cardio-vascular3-6 days per week 30-60 minutes(or accumulate minutes)Moderate intensity*
Strength Training
2-3 days per week8-15 repetitions
1-3 setsTo fatigue*Consistency:
MeaningInstant
GratificationRealistic Stretchin
gAfter each bout
of physical activity
Mindful Stretching /
Yoga and Relaxation
Lifestyle Activity
Move more every day! Gradually strive for 8,000-10,000+
steps per day
(*general guidelines- see exercise professional for individual recommendations)
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•“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
Myth #2: “Just moving more doesn’t count”
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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
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Pocket Pedometers & Activity Monitors
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Steps to success, build the habit1. Week 1:
▫ Track your steps every day for one week
▫ Find your average steps2. Week 2:
▫ Set a goal to add 10% more steps▫ i.e.: 3,000 steps a day average = goal
of 3,300 steps each day3. Continue to add 10% more steps each
week by adding small amounts of activity.
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Mon. Tues. Wed. Thurs. Fri. Sat. Sun.
Steps 1852 2223 3832 1522 2255 3522 1232
Activity Work day
Workday
Work and shop
Meeting all day
Work day
Yard work
Dinner and movie
Comments Could have walked at lunch
Could park further at work
Knees hurt
Felt great!
Tired/lazy
Tracking Steps• Get baseline steps• Wear pedometer all day every day and keep track of steps• Notice where you could possibly add activity
Average Steps per day = 2348 Goal next week = 2582 (10% more per day)
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Mon. Tues. Wed. Thurs. Fri. Sat. Sun.
Steps 2752 2663 3700 1752 2622 2611 2633
Activity Work day
Workday
Work and shop
Meeting all day
Work day
Took a walk before dinner
Cleanhouse
Comments 10 minute walk at lunch
Parked at further from work
Felt lazy Walked at lunch
Felt great!
Tracking Steps• Week 2: Increase by 5-10% from baseline average 2363 steps per day• Goal: 2600 steps per day
This week average = 2676 steps/ day!
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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!”
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Cardiovascular Exercise
• Burns calories• Improves health• Increases stamina• Lowers blood pressure
& blood sugar• Lowers stress levels• Improves mood• Improves sleep• Etc.
•Continuous movement • using as much muscle
as possible• Walking, biking,
swimming, dancing, etc.
•30+ minutes▫Accumulated if
needed•3- 7 days per week•At a moderate pace
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“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!”
Myth #3: I have to sweat to get a good workout
Myth #4: Exercise has to be hard
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Rating of Perceived Exertion Scale (RPE)
0 Nothing at all
1 Very light
2 Light
3 Moderate
4 Somewhat heavy
5 Heavy
6
7 Very heavy
8
9 Very, very heavy
10 Maximal
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“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
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“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”
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“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
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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!”
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Diet Only Diet + Exercise “Normal” Aging
Fat Muscle Fat Muscle Fat Muscle
What do you want to lose?
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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 #5: I will get big bulky muscles
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Myth #6:“Muscle is bad for weight loss/ Muscle weighs more than fat”
Basil Metabolic Rate (BMR) Thermal Effect of Food (TEF) All Physical Activity
Calories burned when in active: 75% has to do with lean body mass (muscle)
Daily movement makes a difference
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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??”
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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•!!!!!!!!!!!!!!!!!!!!!!!
!!!!!
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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)
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“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!”
How much strength do you need for your vision?
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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
Myth # 7 Stretching is not worth the time
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“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!”
How much flexibility will you need?
How relaxed do you want to feel?
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• 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
Keeping Exercise Safe
“I completed the Bare Hill Triathlon”
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Exercise Before and After SurgeryBefore 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!
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“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