May 15, 2017
By Melody Covington, MD
Most people agree that physical activity is an essential component to maintaining a healthy lifestyle. However, it is important to acknowledge that there are challenges to exercise that individuals with overweight and obesity often experience. There’s much more to the “just move more” advice for weight loss. We will explore a few challenges to exercise and potential solutions in this article.
#1. Exercise Is Difficult and Uncomfortable
Exercise does not have to be difficult. Obesity specialists often exchange the term exercise for physical activity. Exercise is associated with a negative connotation of arduous, unobtainable, and unenjoyable labor. This creates a mental barrier for many people. Physical activity is more acceptable and conveys simply moving. Physical activity can involve parking farther from the store, taking the stairs instead of the elevator, or breaking up an hour walk in 10 minute increments over a six-hour period; all are suitable means of obtaining daily physical activity. The adult recommendation for physical activity is one hour a day, most days of the week, and this can be easily obtained by walking one hour a day. This is easy, safe, and can be very enjoyable. To add, walking is effective for both the weight loss and maintenance stages of weight management.
#2. Physical Activity Increases Hunger and Cravings
As the body increases energy expenditure in the form of increased physical activity, systems within the body will work to defend the set point (the body’s programmed weight locked within the hypothalamus). As more calories are burned, the body will compensate for the loss in fat by increasing hunger signals and reducing satiety. This leads to overeating, large portions, and ingestion of comfort foods. The end result is eating back calories lost from physical activity. To combat this physiological routine, first always eat properly and do not “over-diet.”
During the weight loss process it is tempting to cut calories too low, and this causes key nutrients to be lost as well. Although the scale may go down quicker in the beginning, it is deceiving; the weight loss is typically only water and muscle weight and not fat. Severe caloric restriction not only results in muscle loss but reduces metabolism, making it harder to lose additional weight (weight loss plateau) and easier to gain subsequent weight. This cycle also leads to even more food cravings!
When increasing physical activity, always start with a well-balanced and proper diet. Eat adequate protein and healthy fats to reduce food cravings and help with satiety. In addition, be sure that the feelings or thoughts of hunger and craving are legitimate. “Head hunger” is more related to a psychological hunger than a true physical hunger and is natural when making dietary changes. Cravings are sometimes related more so to habits than true physiological need for a nutrient or food. Obesity is a disease and for individuals who need to lose weight to eliminate chronic medical conditions or prevent disease, it is sometimes necessary to employ the help of an obesity clinician well-versed in FDA-approved weight loss medication to help with hunger, cravings, and metabolic preservation.
#3. Individuals with Overweight and Obesity Are More Prone to Workout Injuries
This can be true depending on the extent of excess weight and the types of physical activity. Increased torque on weight-bearing joints, especially the knees and ankles, can increase the risk of injuries for individuals carrying excess weight. It is important to avoid injuries that can lead to diminished mobility, as this will not only reduce confidence in physical activity but also increase the risk of additional weight gain. Stretching, slow progression, working with certified physical instructors experienced in bariatrics, and patience are key to starting an exercise regimen. Proper nutrition, rest, and listening to the body to differentiate muscle growth from dangerous muscle pain are also key to avoiding injuries from physical activity. For individuals with 100 or more pounds of excess weight, consider starting with chair exercises, water aerobics, and bike riding. These activities are safer, gentler on the joints and still effective for cardiovascular fitness and weight reduction.
#4. Consistency Is Hard
Physical activity is one of the most essential factors to weight maintenance; however, consistency is extremely difficult to maintain. Exercise serves as a great buffer in weight maintenance because caloric intake, stress, sleep patterns, food intake, and metabolism will not be consistent. As caloric intake and other metabolic factors fluctuate, physical activity serves as a method for energy expenditure to offset factors that impede weight loss. Ways to increase consistency with physical activity include: finding an activity that is enjoyable, creating accountability (can be in the form of fitness trackers, calendars, and accountability partners), and group fitness.
Exercise is not always easy, yet it is often suggested as a solution to weight loss as if it were effortless. It is important to remember that there are several challenges that create boundaries for engaging in physical activity. Finding strategies to overcome barriers to physical activity is essential to obtain physical fitness goals and ensure not only proper weight loss, but most importantly weight maintenance.