How exercising before weight loss surgery boosts your chance for success

I am one week out of surgery. If it wasn’t for the exercises, I would of had a much harder time. I had plenty of strength right after surgery. I am strong in places I didn’t realized would be. The exercises before surgery help me so much with getting up and doing other things in these early stages of recovery.

This is a patient, who was a regular exerciser when younger, had a major back injury from a work related accident struggled put that on hold for a long time. Living with pain for many years had taken its toll on him not only physically, but mentally too.

When he committed to having surgery, he committed to regular exercise. He purchased exercise bands so he could exercise at home. He started walking short walks, listening to his body and not pushing through pain. He added small stretching breaks to his day to keep his body feeling as good as possible each day.

Motivation was also an issue. The gym used to be motivating but now it was a stark reminder of how far he had come from his younger more fit self. It made him feel worse and that led to put off going. He knew he needed to move more but was afraid of making things worse and struggling with motivating to get started. Doing a little at a time, at home where he felt comfortable helped him get out of the overwhelming state of thinking about how far he was from his goal. Instead he focused on what he could do to feel his best each day. He also committed to regular exercise visits every few weeks to ensure he was staying on track.

This is the struggle for most people who are trying to lose a large amount of weight. You know you need to exercise but your body is limited. You cannot just jump back into what you used to do or what everyone else is doing. You are in a unique situation and need exercises that are meant for the state of your body and your mind right now. This is why we need exercise programs that are specifically for people who are preparing for weight loss surgery.

The problem is, the area of prehabilitation before weight loss surgery has very few studies and most bariatric surgery programs do not include professional clinical exercise guidance as part of the preparation.

The current research shows that exercising before weight loss surgery provides the benefits that make surgery and recovery easier for your body and improves your chances of success with weight loss surgery. The key is, only exercise can provide all these benefits.

One of the most important benefits unique to exercise is the improvements in muscle strength and the prevention of muscle and metabolism loss with weight loss. Muscle loss is one of the down sides of weight loss surgery. Rapid weight loss has been shown to lead to loss of muscle mass, which is one of the largest parts of your metabolism. In one study, people who didn’t exercise after surgery, 22% of their weight loss was muscle. No wonder it is so difficult to keep weight off! But studies show those who exercise greatly slow or even prevent this loss during weight loss.

The common thought is that people who are carrying extra weight tend to have more muscle mass, and this is true but they tend to have lower muscle strength. This is like having a really cool sportscar in your driveway but not being able to use it. Strength and muscle mass don’t go hand in hand because strength is the function of muscles. That depends on how you use them. Exercise, specifically strength training, tells your muscles how to function well and be strong. Only exercise can do this for you. Since functioning better in daily life is one of the main reasons for weight loss surgery, exercise is an essential part of success.

Studies support other benefits of exercising before weight loss surgery is:

  • better blood pressure control
  • better blood sugar control
  • decrease of inflammation
  • improvement of cardiovascular function (Ie; less shortness of breath, lower risk of heart attack, more energy)

If you want to lose weight to be healthy, isn’t it nice to know you can be healthier while losing weight!

Fitness is a measure of your function in daily life. The image above shows that people represented by the grey line, who didn’t exercise before or after surgery don’t improve their fitness levels after weight loss surgery. Having weight loss surgery is too much work to miss out on this key benefit of weight loss!

As shown in the top two lines in the chart, people who exercise improve fitness and thus are probably enjoying the most success from weight loss surgery. Notice though, the people who do best are the ones represented in the blue line. They are the ones who exercise before and after weight loss surgery.

Exercising before weight loss surgery is one of the best ways to prepare for surgery and up your odds of success after weight loss surgery. Exercising prepares your body by giving it the strength and stamina it needs for surgery and recovery. You are also preparing your mind for making exercise part of your lifestyle, so you stay strong and function better with every pound lost. If you feel stuck, unable to exercise, know that the problem is not your mind or your body. You simply need exercise that is specifically for you, someone who is preparing for weight loss surgery. When exercise addresses the unique needs of someone preparing for weight loss surgery, those physical and emotional struggles with exercise are much less.

Hopefully in the future more research will provide the incentive for more bariatric programs to make exercise a part of their program. UMass Memorial Weight Center is unique in their commitment to including clinical exercise support and guidance as part of the preparation for surgery and success after surgery. If you are preparing for weight loss surgery, make the commitment to include exercise as part of that preparation, seek guidance and support from professionals who understand your unique needs, and give yourself the best chance for success before and after surgery.

Keep Moving, Be Well,

Janet

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by | June 29, 2021 · 2:03 pm

Ready to get out of the all or nothing exercise mindset?

Are you an all or nothing exerciser?

If you are noticing this approach is not really working for you anymore, there is a way out.

All or nothing exercise comes from the idea that more exercise is better for weight loss. The whole approach comes from the calorie concept. If you only burn 50 calories that does not make a dent in your dinner much less the treat you had after so what is the point? One problem is that weight loss is more than calories in and calories out.

The bigger problem is how this mentality blinds you to the real benefits you are getting, beyond the scale, from even a short bout of exercise. The way out of all or nothing is to look beyond the scale, because even if you really want to lose weight, that is not the ultimate goal. Really?

Yes! I am willing to bet you do not want to get to a goal weight and feel worse; less energy, more pain, less capable of doing the things you want to do. The number on that scale is not your success. How you feel and function better is your true success.

Let’s say you want more energy. You decide the weight is making you tired so you set out to exercise to help you lose weight. You restart an exercise program and instantly remember how great you feel from exercise. You have more energy you are sleeping better, less stressed. But then the scale does not budge and you say “this is not working!”.

If the “all” part of you wins out, you ramp up the amount of exercise to really jump start that weight loss, feel exhausted but believe you are making progress.

If the ‘nothing’ part of you wins out, you stop exercising and mentally beat yourself up for being so ‘lazy’.

The third option is to be mindful.

Mindfulness is not meditation, its a way of being present to what is happening right here, right now, with curiosity and kindness. This third option means you notice what you are getting from what you are doing. You see clearly that you are in fact getting what you want from weight loss; more energy!

With mindfulness you stay curious rather than critical, so you can look at what else may be happening that is keeping your weight stuck. The kindness part of mindfulness keeps you from giving up on yourself. It keeps you from putting your down. Instead, it reminds you to talk to yourself like you would a good friend who it trying to lose weight.

Mindfulness has been shown in research to be very powerful with long term motivation. The bonus is, you get to improve your focus and ability to stay calm when life gets stressful.

In the next blog, I will talk about why that bonus is a key to weight loss.

For now, if you tend to be an all or nothing exerciser, try mindfulness and see what happens when you step back, stay curious, and be your best ally.

Keep Moving, Be Well

Janet

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by | June 8, 2021 · 9:18 pm

The real way to exercise to get results

Getting results is the big motivator for exercise isn’t? When you see the scale, your measurements or clothing size go down, when you look better in the mirror it means exercise is working. Yet, the lack of these results means it’s not working and your motivation takes a nose dive.

We all want results. Its the whole reason we are motivated to do anything. The more instant and the more tangible, the more your brain lights up. But exercise results are not instant. The scale, measuring tape, and clothing size makes them feel tangible. But, have you ever stopped to think about who decided those are the results of exercise?

We live in a culture where being fit is a look. We measure exercise by the calories it burns or the steps you get (which is another way of measuring calories burned). We have been led to believe that the feeling of the burn in muscles is your body burning off fat. This has led to a whole list of exercises and machines for the sole purpose of burning fat off certain areas of your body so you can sculpt it into the shape you want.

Along the same lines of melting fat, sweat has come to mean a ‘good workout’. It has been assumed that if you are sweating you are burning more fat, melting it off your body.

Pain has also been associated with progress. The ‘no pain no gain’ mantra that was invented to tell athletes pain is just a side effect of gaining a competitive edge has morphed to mean that you need to feel pain to make progress.

So we are inundated with media images of people doing exercises and looking ‘toned’, sweating and looking trim and in pain and looking fit. These images trick our brain into believing that our body can be molded, trimmed and sculpted if you are just dedicated and tough enough to push your body to exercise in this way.

Keep in mind, the whole premise of marketing is to make you believe you are not enough. The way the body changes slowly is just not marketable. The facts about how you really cannot choose where your body burns fat is also not going to make anyone millions of dollars.

With this awareness, you can look at everything you see in the media and question if its marketing science or body science.

The fact is exercising a certain area will not make you lose fat in that area of your body. That means toning is a term that is marketing based not science based. There are only a handful of scientific evidence that you MIGHT be able to change the look of your skin through strength training. Cardio machines that ‘work’ certain areas of your body and ‘toning’ exercises’ made to give you long lean muscles have no scientific basis.

Another fact is that more is not better. Exercise does not need to be high intensity for weight loss. Soreness does not mean you are making progress, it means you have slowed progress in getting stronger. High intensity and muscle soreness make more work for your body to heal and repair. More than is needed for health and for weight loss.

Exercise works best when you do it consistently. Your brain is hardwired to avoid what makes you feel worse. If high intensity exercise leaves you feeling physically or mentally worse, it will not work for lasting weight loss. Real results come from consistency not intensity.

The results you really want from exercise for weight loss is to feel and function better. What good would it be if you got to a goal weight but felt worse and could not do all the great things you wanted to do? The purpose of exercise is to make you feel better now, and function your best in the future. Those are the real results from exercise, based on body science.

Take a moment to question what you consider results from exercise. Define your own results based on how you want to feel and what you want to be able to do. Any time you see results in the media and are tempted to do an exercise that looks hard and painful but that promises to change the look of your body, question the motive. The job of marketing is to tell you all the ways you are not enough so you have to keep coming back for more, never feeling satisfied with how you look. The job of exercise is to remind you that you ARE in fact enough, no matter your size, so you want to keep coming back for more because it makes you feel better every time.

Keep moving, be well

Janet

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by | June 1, 2021 · 9:12 pm

Breathe. Go easy on yourself. Keep Moving.

Busy week! Have you had one too? A friend sent me this quote today. I thought I would share in case you needed the reminder to breathe, go easy on yourself and keep moving.

Be Well

Janet

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by | May 18, 2021 · 8:20 pm

“You don’t have to wake up in pain because you exercised”. A patient’s story.

“Everyone has been asking me ‘what changed?’ because I’ve been smiling so much the past two weeks”.

This was what a patient said to me today at a follow up visit.

Her response to them was “My workout changed! I am no longer in pain when I wake up! It feels so good to not be in pain!”.

When we spoke two weeks ago, this highly motivated woman preparing for weight loss surgery was exercising five days a week, three of those with a trainer. The trainer had just taken the program up a notch because she was not losing weight.

She described constant back pain and muscle soreness, but continued to go to the gym. “I just have to lose weight” was her justification for the pain. “It will be better when I lose weight”

We discussed why weight loss was important to her. “I want to be around for my kids. I want to be able to play with them and have fun with them again”, she said without hesitation.

Clearly, she is motivated to lose weight and her reasons are very value driven. She was doing everything she was told she was supposed to do to get to that goal. She had changed her whole diet and was very careful to stay on it. She paid for the month with the trainer in advance to keep her accountable so she would be sure to stay motivated to go to the gym.

The results… pain and fatigue. She was too tired to play with her children and the frustration was written all over her face.

When she described the workout she was doing at the gym, I was concerned what she was doing was not right for her elevated blood pressure and putting her health at risk. I proposed a different kind of exercise challenge; to let go of what she though she had to do and try a different way to exercise. I challenged her to try it for two weeks using the online programs we offer to patients and see how she feels. She agreed.

Today was the two week mark. The smile on her face said it all! She has been consistently doing strength training, treadmill walking and yoga at home. She said it feels so much better and has more energy and is happier all day long. The best part though is that her kids have been doing it with her! “we have so much fun doing the videos! they love them!”.

She is not only exercising regularly without pain, she has accomplished her goal for weight loss – to be able to play and have fun with her kids again!

“I want people to know you can workout and not wake up in pain.” She said to me. “It’s a miracle”.

Really it’s just the way our body is designed to move.

If you are in pain from exercising, please know you do not deserve to be in pain just because you are carrying extra weight. There is another way to exercise. Take the challenge and see for yourself.

Keep Moving, Be Well

Janet

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by | May 11, 2021 · 9:29 pm