Tag Archives: Weight loss

Stress and exercise

Why exercise for diabetes_(10)

All you have to do is watch the news, and stress level begins to rise.  Then there are the usual stressors of work and family, plus the bigger stressors that pop up and you have a mind and body that are working overtime.   These mental stressors are part of life, but they can also lead to weight struggles.

Within seconds of a stress response, chemicals (catecholamines) change every system in your body;  Your heart rate increases, blood vessels constrict in your digestive system and your skin, your liver pumps glucose into your blood, your brain narrows its attention to deal with the ‘problem’.

The catecholamines also signal your body to release cortisol.  This chemical suppresses appetite immediately but after some time it then stimulates appetite and the preference for food that is rich in fat and sugar (ie: comfort food).  Cortisol is also known to cause fat to be deposited around the abdomen. Cortisol also increases your body’s insulin resistance, making it more likely those sugars will stay in your blood system.  This chemical also also changes cells in organs in a way that can lead to asthma and eczema as well as pain, gastrointestinal symptoms and panic attacks.

When the stress response is prolonged, it can lead to conditions like: anxiety, depression, type 2 diabetes, fibromyalgia, loss of muscle mass, osteoporosis, high cholesterol, hypertension, and heart disease.

When you are carrying extra body weight there are additional factors that can lead to chronic stress too.  Experiencing weight discrimination, having more health concerns and symptoms such as pain and sleep apnea all keep cortisol levels high.

Add to that other factors such as smoking, excessive alcohol use, and some medications like antidepressants and steroids also increase cortisol levels.

This can create a spiral where higher cortisol increases weight and weight gain increases cortisol.  When we think of weight loss as simply moving more and eating less, we miss this major hidden factor that is contributing to weight – stress.   Then, when going on a diet and exercising are stressful, it can speed up this cycle rather than reversing it.

While all of this may seem overwhelming, the way out is closer than we think.   It is found in understanding why your body does all of those changes in response to stress.

When you are in a stress response your body is preparing to protect you by preparing you to move; to run away from or fight a stressor.  We all have heard the stress response called the ‘fight or flight’, and that the problem is that our modern day stressors are not solved by fighting or fleeing the ‘danger’.  The bigger problem is that we have made exercise stressful, reducing the chances it will be able to take you from the stress response back to the state your body can heal and repair.

The answer is found not in more exercise, but instead carefully designing movement time so it is stress reducing by:

  • Focusing on what you are doing, not multitasking to just get it done
  • Moving the way your body was designed (hint: it was not designed to do sit ups)
  • Doing just the right amount for your body now,  not exercising to a point of pain or exhaustion

The fact is, only you know if exercise is stress producing or stress reducing.    It starts with knowing how your body is designed to move, staying away from marketing based exercise programs.   Then listening to your body so you know how it moves well now, at your current shape and size.

It’s not only possible for exercise to reduce stress, it is essential if exercise is going to lead to weight loss and improved health and well-being.

The bottom line is that exercise is the antidote to stress. It is what your body needs when you are stressed in this modern society.  Take time to move in ways that help your body lower your cortisol levels now, and it will thank you by getting back to its job to keep you healthy and well.

Keep Moving, Be Well,

Janet

Source:

Stress and Obesity: Are There More Susceptible Individuals? Eline S. van der Valk et al. Current Obesity Reports(2018)

 

 

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by | September 4, 2019 · 7:11 pm

The weight loss you don’t want

Why exercise for diabetes_(9)

When you are trying to lose weight, every pound down on the scale is exciting.  It’s an affirmation that what you are doing is working.

Or is it?

If the goal is just to lose weight, regardless of your health or how your body feels or functions at the lower weight, then yes, it is working.

But if your reasons for losing weight are to feel and function better, be healthier, live longer and look better, research is affirming the scale is not the best tool.

Weight loss can be up to 30% muscle loss. This the weight loss you don’t want! It turns out, muscle is more about our health and longevity then we ever thought. Here is some of the recent research backed connections between muscle loss and health:

  • Joint Replacement:  Patients who had less muscle mass had more complications, slower wound healing, increased risk of infections and longer recuperation after  total knee replacement surgery.
  • Cancer: Patients who had lower levels of muscle mass had reduced ability tolerance of treatment. Patients with less muscle mass having surgery for colon cancer had a higher incidence of both blood transfusion and complications after surgery.
  • Gastric Sleeve:  Patients with lower muscle mass were at greater risk of a leak after having a sleeve procedure for weight loss.
  • Osteoporosis:  The loss of bone and muscle have a huge impact on how a person ages.  Researchers now know that there is a strong connection between loss of muscle and loss of bone.  Researchers are asking we think of muscle loss and bone loss one disease because they know that increasing muscle mass has a direct effect on improving bone mass.
  • Others:  Reduced muscle mass has been connected to increased risk of falling, bone fractures, reduced longevity, fatigue, arthritis, as well as emotional health including depression, anxiety, and social isolation.

The medical name for muscle loss is Sarcopenia and it is now considered a disease.  However, this is not the kind of disease a medication can fix.  Muscle, like the rest of your body is a use it to keep it commodity.  The way to keep it, or get it back if you lost it is through strength training exercise.

sarcopenia

How do you know if you are losing muscle?  Well, that is part of the problem.  Measuring muscle mass has not been quite as convenient as getting on the scale.  Fortunately, researchers have found there is an easier way to test muscle loss. Its called a hand grip test.  It is strongly connected with how much muscle mass you have.  No tool is perfect, but this is one of our best ways to know if you are holding on to your muscle mass as you age and as you lose weight.

Soon, we will be incorporating this test as part of our measurements before and after weight loss surgery to give you another number to see how you are doing.  Since the connection between muscle mass and health has the potential for being a reliable measurement of true progress with weight loss for health, these numbers are ones to pay attention to as you lose weight.

Keep Moving, Be Well

Janet

 

Sources:

  1. The impact of sarcopenic obesity on kneeand hip osteoarthritis: a scoping review Godziuket al. BMC Musculoskeletal Disorders (2018)
  2. Preoperative grip strength measurement and duration of hospital stay in patients undergoing total hip and knee arthroplasty A. J. Shyam Kumar. European journal of orthopedic surgery, July 2013
  3. Is sarcopenia a better predictor of complications than body mass index? Sarcopenia and surgical outcomes in patients with rectal cancer Colorectal Disease  SB Jochum, 2019, 
  4. Preoperative Detection of Sarcopenic Obesity Helps to Predict the Occurrence of Gastric Leak After Sleeve Gastrectomy, Martin Gaillard, Obesity Surgery August 2018
  5. Osteoporosis and sarcopenia: two diseases or one?, Jean-Yves Reginster, Current Opinion in Clinical Nutrition and Metabolic Care, Jan. 2016
  6. Interaction of nutrition and and exercise on bone and muscle, Endocrinology 2019
  7. Sarcopenia FDA report, April 2017
  8. Sarcopenia is a disease –  why are we looking for a medication.? The Conversaion

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by | August 27, 2019 · 7:30 pm

Exercise and Osteoarthritis

Why exercise for diabetes_(5).png

What is Osteoarthritis?

In normal joints, a firm, rubbery material called cartilage covers the end of each bone. Cartilage provides a smooth, gliding surface for joint motion and acts as a cushion between the bones. In osteoarthritis or OA, the cartilage breaks down, causing pain, swelling and problems moving the joint. As OA worsens over time, bones may break down and develop growths called spurs. Bits of bone or cartilage may chip off and float around in the joint. In the body, an inflammatory process occurs and cytokines (proteins) and enzymes develop that further damage the cartilage. In the final stages of OA, the cartilage wears away and bone rubs against bone leading to joint damage and more pain.  Arthritis Foundation Website

How does exercise help?

Exercise is considered the most effective non-drug treatment for reducing pain and improving movement in osteoarthritis. Arthrtis.org

Movement in general can reduce inflammation, the cause of pain in arthritis.   Your lymph system relies on movement to keep this fluid part of your blood moving so your body can lower inflammation.  All three types of exercise work well for osteoarthritis:

  • Stretching reduces stiffness that makes movement more difficult.  Simply moving a joint through its full range of motion a few times several times a day can be very beneficial in reducing stiffness and movement limitations from OA
  • Strength training helps your muscles, ligaments and tendons support arthritic joints. Strength training has been shown to reduce arthritis pain.  The key is knowing how to do strength training with proper alignment so your joints work there best and you minimize strain.  In your exercise visit, we practice this to ensure strength training is not painful so your body can gain strength without strain.
  • Cardio can reduce pain, but there are several factors to consider.  If the activity is weight bearing (such as walking), your joints probably won’t tolerate it for as long. However, since walking is a type of activity needed for daily life, it is important to incorporate if at all possible.  Use a cane or walker if it helps you walk with less pain.   Walk in several short bouts for the duration that does not increase pain.  Supplement with a form of cardio that is non-weight bearing and allows you to move for a longer period of time,  such as an exercise bike or seated aerobics. The key is doing the amount and type that decreases, not increases pain and then repeat that more frequently to make up for the lower duration.

The key to each of these  is listening to your body.   When movement decreases pain, it is lowering inflammation.  When pain increases, so does inflammation.  So doing small bouts throughout the day, doing the types of exercise that reduce pain and stiffness is the way to use exercise as the most effective non-drug treatment for reducing pain and improving movement in OA.

One last thing to consider is stress.  If exercise or physical activity is stressful, it will increase inflammation.  Choose types of movement you enjoy, that leaves you feeling good about yourself, and do it in a way that it does not increase your pain, and you will be using exercise in the way that it can make it easier to live with osteoarthritis.

In the next blog, I will address why exercise is important if you are having  joint replacement surgery.

Keep moving, be well,

Janet

Sources:
Exercise in the management of knee and hip osteoarthritis. Elizabeth Wellsandt and Yvonne Golightly. Current Opinion in Rheumatology. 30(2):151–159, MAR 2018
Educating patients about the benefits of physical activity and exercise for their hip and knee osteoarthritis. Systematic literature review. C.Gay, A.Chabaud, E.Guille, E.Coudeyre.  Annals of Physical and Rehabilitation Medicine.  June 2016, Pages 174-183

 


Please share these posts with anyone you know interested in losing weight with or without weight loss surgery.  Click here to learn more about the UMass Memorial Weight Center

These weekly blogs are general guidelines. These guidelines apply to patients who are cleared by a physician for the type of exercise described. Please contact your physician with any concerns or questions. Always report any symptoms associated with exercise, such as pain, irregular heartbeats, and dizziness or fainting, to your physician.

 

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by | July 9, 2019 · 7:30 pm

Exercise and diabetes

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If you have been told your blood sugar (glucose) is too high, you probably have also been told to exercise.  But why?  Knowing how exercise helps lower blood sugar levels is a key for staying motivated to exercise regularly.  Let’s take a look at the inside story of exercise and blood sugars. 

Sticky Blood: When sugar gets wet, it gets sticky.  One of the biggest problems with having high blood sugars is that sugar makes blood “sticky”.   When sugar is at higher levels in your blood for too long, it is concerning because that “sticky” blood is now traveling to every part of your body.   This is why diabetes puts you at risk for so many different medical issues.  Nearly every part of the body is strained when blood sugars are high; your kidneys, your nerves, your eyes, etc.

Natural blood sugar management: Two of the most important ways your body is designed to move sugar out of your blood after you eat is (1) the movement system (2) the insulin system.  The movement system is meant to be the main system for keeping blood sugar from getting too high. The insulin system is designed to be your back up system, for use when you are not moving.

When you move:

  • your body uses the sugar in your blood to help fuel moving muscles
  • your body is able to use its own insulin more efficiently.  After exercise, your body is more sensitive to its own insulin, making this back up system work better for hours after exercise.

When you don’t move often:

  • your main (movement) system for managing blood sugars is not available
  • your body needs to use the back up (insulin) system to bring sugar into cells to be stored as fat
  • over time your back up (insulin) system gets overused and can ‘wear out’

When you have type II diabetes, your body is resistant to insulin, causing sugar and insulin build up in your blood.   When you move your body, you activate the main natural system for lowing your blood sugar.   Exercise then, temporarily reverses the cause of type II diabetes.

Not all movement is created equal.  However, if you move all day for your job or for child care, your movement system could be counteracted by another system – the stress system.  When you are moving but stressed, your body releases more sugar into your blood.  That means the movement system cannot do its job as effectively.  This is what sets exercise apart from your every day physical activities.  Exercise is when you are moving for the purpose of self-care. When movement reduces, rather than increases stress, it is able to do its job of lower blood sugars. 

Plus, exercise has GREAT side effects. The bonus is, exercise also helps you manage diabetes in other ways too:

  • Think clearly:  Moving your body can help your brain function better, giving you a better mood, focus and ability to make healthy choices
  • Health protection:  Regular exercisers have a lower risk of heart disease, cancer and stroke.  When you have diabetes you are at greater risk for health concerns, so the extra protection from exercise comes in very handy.
  • Weight managementExercise (specifically strength training) counteracts the metabolism lowering effect of dieting by keeping your muscles strong and functioning well while losing weight.
  • Improved sleep: When sleep deprived, the stress response in the body is triggered, raising blood sugar and making weight loss more difficult.  Using exercise to improve sleep has a ripple effect to many other parts of your life.
  • Reduce Arthritis pain: stronger muscles around joints can decrease arthritis pain and make moving easier.  Less pain means you can move more and moving more helps keep blood sugar in check.
  • Reduce Back Pain:  The job of the core is to protect the spine from wear and tear. Exercises that teach the core muscles to do their job in a functional way can reduce back pain.  Plus, stretching in a way that helps to improve tolerance of things like bending and lifting and helps the body recover from strains of daily life can reduce back pain flare ups. Again, less pain, more movement, better blood sugar control.
  • Counteracts depression, anxiety, and improves mood and focus:  Exercise, when used properly, has been shown to be very effective as part of a treatment plan for depression, anxiety, ADHD, and other areas of mental health.  Living with a disease like diabetes can be overwhelming at times and can affect mood.  Exercise can help boost your ability to cope with the stress and pressures of having diabetes

Bottom line:  Moving your body, in a way that reduces stress, activates the natural blood sugar management system in your body.  Keep moving to keep this system working for you and your health.

Keep Moving, Be Well,

Janet

 

 

 

 

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by | May 28, 2019 · 8:55 pm

How to lose ten pounds of gym guilt

how to lose ten pounds of gym guilt(1)

The trend in affordable gyms has made it so much easier for many people to exercise year round.

It has also expanded the problem many people have with a gym membership  – gym guilt!

In trying to get more exercise, you might be tempted to join a gym because it’s only $10 a month.    As you may have discovered, your exercise motivation depends on A LOT of factors so getting to that gym might be not so easy.   You may be busy right now and just cannot fit it in.    Often, when trying to lose weight, walking into the gym feels like a spotlight is shining on your extra weight. It’s just too embarrassing to go right now.   You might wait until you feel better about your body and then you will start.

The bigger problem with these low cost memberships is that they are not expensive enough to make you end the membership if you are not going.  When things calm down a bit, or when you lose some weight, you will go, so why cancel it?     In the meantime, that membership fee on your credit card statement each month is a constant ‘weight’ on your mind. Its a constant reminder that you are not exercisign the way you ‘should’.

(No, I am not reading your mind, you are just not alone in this. I see it all the time!)

Lets talk about how to lose the weight of that gym guilt.  Here are some questions to ask yourself so you can finally make peace with using, or losing your gym membership.

  • Is it the commute? Does it take more time to get to and from the gym than its worth?  If your time is limited, no matter how inexpensive the membership, you probably will not to choose to spend your time on a gym commute on a consistent basis.
  • Is it the environment? When you walk into the gym, how do you feel?  Happy to be there or counting the minutes until you can leave? That initial instinct about the gym is so subtle, you may not realize it is the reason your brain finds excuses not to go.  Either find a way to make it more comfortable for you or find a new place to exercise.
  • Is it the people?  There is a definite vibe in each gym.  Some are welcoming and friendly in a very authentic way.  Some are ‘friendly’ in a “my boss told me to say hello when members walk in so I am going to flash a fake smile and say a cool hello” kind of way.  Some gyms are meant for people with very definite exercise goals. If they are not the same as yours, you may feel unwelcome, no matter what you do.  Either give yourself a pep talk reminder that the attitude of others is not your concern or find a more welcoming place to exercise.
  • Is it equipment overload?  It seems that the less expensive the gym, the larger and more daunting it can be.    If you feel overwhelmed by the equipment choices in the gym, know that much of that equipment is not useful anyway.  Find the machines right for you and  stay focused on that.  You don’t need to do everything that is in the gym.  Get a comfortable routine going and do what you enjoy most. (well OK more than the sauna and massage chairs!) When you are ready for a change, learn only one new machine at a time to stay out of overwhelm.
  • Is it too crowded when you go?  Rush hour times at the gym are about as much fun as rush hour time on the highway.  If the crowds are getting in the way of efficiently enjoying your gym time, and you cannot go at another time, seek alternate routes to exercise.
  • Is your body not ready yet?   Some types of exercise are not great for starters.  The elliptical for instance starts at a higher intensity. If you are just starting out you are likely to feel like a failure in about two minutes flat.  Group exercise classes can be motivating but they also are more likely to make you do too much too soon. Gain skills in listening to your body before joining a group. Choose the types that feel best for your body to start and gain some stamina, strength and body knowledge before expanding to other more challenging forms.
  • Is it lack of know-how?  There is no time in adult life that we learn how to exercise correctly.  If you don’t know how to exercise, you are not lacking some skill that everyone else has.  There is a lot of useless exercise information available out there, much of it based on what is marketable, not how your body is designed.  If it does not feel good, it is not good for you.  If you are a UMassMemorial Weight Center patient, contact me to chat about how to strengthen your exercise know-how

Some times the healthiest decision is to let go of the gym membership and exercise at home or someplace else.  Most importantly, lose the gym guilt, it’s is not helpful for your mind or your body.  There are plenty of other options out there and exercising at a gym is not right for everyone.   Find a way to make it work or let it go.

Keep Moving, Be Well,

Janet

 

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by | April 17, 2019 · 7:13 pm

“Exercise is Medicine for a Good Day”

consistency is the holy grail of exercise(1)

This is the patient quote of the week. I could not have said it better myself.  Design your exercise time, no matter how long or short it is, to be your medicine for a good day.  Enjoy!

Keep Moving, Be Well,

Janet

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by | April 10, 2019 · 6:45 pm

Exercise motivation from an unlikely source

How calorie burning makes it harder to lose weight(12)

This article gives a surprising yet research backed perspective about will-power and making changes that stick.  It is pretty clear that our old way of  making exercise a habit works against us.    If you think exercise has to be hard, and you just need more self control to make yourself do it until it becomes a habit, there is a much more effective way.

We’re using tools that aren’t only weak; they’re also potentially harmful. If using willpower to keep your nose to the grindstone feels like a struggle, that’s because it is.

It turns out too, this way also puts a drain on our health

Those who were better at using self-control did have more success when it came to resisting temptations, but at a cost to their health. Their bodies suffered not only from increased stress responses, but also from premature aging of their immune cells.

What is this unlikely source that is better for our motivation and our health than good old fashion self control?   Fostering emotions like gratitude, compassion and awareness of your own strengths has a better track record for both sustaining motivation and for promoting health.

This is one of the most challenging mindsets to change about exercise.  From my experience the belief in grit, willpower and self discipline comes from the place many of us learned about exercise – through sports.  Think about it, athletes make up the majority of our images and messages about exercise in our culture.    They have amazing self control and discipline and achieve amazing levels of fitness.  How could that model steer us wrong?

An athlete has plenty of reasons to push through and stay disciplined – the competition, team mates, coaches, records – all of these external motivators drive willpower.   We ‘regular folks’ don’t have all of those, so we replace them with other external motivators –  weight goals, challenges, competitions, social media, and accountability partners.

The research is pretty clear though.  Trying to make yourself have more discipline and willpower is stressful and not built to last.   That stress strains health and energy.  It works, but it is just not sustainable, nor is it helping with exercising for long term health.

The easier and more lasting way to motivation for exercise is to  practice the skills of gratitude, compassion and pride (awareness of your personal inner strengths).

If your New Years Resolutions have faded, it may be time to dust them off and look at them through the lens of our updated understanding of lasting motivation.  You could:

  • Keep a gratitude journal, writing down one thing each day that you are grateful for about how your body moved that day
  • Practice a brief self-compassion meditation a few days a week, so you are practiced up on your skill of self compassion for those times you might use self criticism to make you motivated to exercise.
  • Do a Strength Survey to raise your awareness of your inner strengths and how you can use them to keep you motivated to exercise when life tries to get in the way.

How to you use these tools already to keep yourself motivated?  What else could you do to move away from trying to have more willpower to applying these positive emotions to help you keep moving and stay well?

Keep Moving, Be Well,
Janet

 

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by | April 2, 2019 · 6:04 pm