QOTD: Fitness and fatness

From Reuters, on a study in patients with coronary artery disease that looked at fitness levels and BMI:

[Heart specialist and study leader Dr. Francisco] Lopes-Jimenez said, the lesson for patients is clear: try to improve your physical fitness. “It is much easier to become fit than it is to become slim,” he said. “Anybody who has gone into an exercise program would agree with that.”

While Lopes-Jimenez seems to presume his patients want to exercise (or otherwise take action to improve their health) it is radical to see a heart specialist stating that a person can improve their fitness without being slim.  Or that exercise doesn’t automagically cause slimness.  Or that it can be easier to become fitter than to become thinner — which has certainly been true in my case.

Note to Self

Dear Self –

Yes, if you are going to spend your weekend wandering around a warehouse helping to make a music / circus / vendor event happen, then by all means, take an extra B12 if you think it will help.  Even an extra 2500-iu, if that’s what you have handy…

But don’t be surprised if you are totally dead in following days when you drop back down.  In fact, it might be a good idea to only drop by 1000-iu at a time.

Feeling stupid for not realizing this sooner,
– Me

Exercise and Reinforcing Spirals

I’ve written about my mother being self-conscious about her fat. Afraid of other people thinking she was fat, afraid of not being able to walk far enough, of not being able to find a chair that fit, of being unable to defend herself if physically attacked. Mom was also self-conscious of being out of shape and having an “ignorant-sounding” accent.*

Mom broke her leg when I was 10. She was 45. Spending months with her left leg in a cast from hip to toes probably atrophied some muscles. I quickly learned to tighten my core muscles so I could help her up off the couch without hurting my back. I don’t recall Mom doing physical therapy when the cast got off; I do recall that after that year she gardened less, walked less, and generally seemed less active.  Arthritis seemed to bother her more; her back pain became more severe.  She began to see a chiropractor regularly.

It was a few years after the cast came off that Mom’s best friend, who she’d routinely gone shopping and to lunch with, ended up moving away.  During prior summers Mom and her best friend would load up kids, coolers, blankets, towels, and so forth and take us off to one of the local parks most every day.  Without her friend, though, Mom decided the park was too crowded. Wrangling kids and a cooler and blankets and towels and so forth around a park may not have been all that much activity, but it’s certainly functional fitness.

By the time I was 15 or 16 I was doing all the Christmas shopping so that Mom could “avoid the crowds” at the mall; a few years later Mom confessed that she didn’t think she could walk the length of the mall anymore.  I carried a pillow into movies so she could sit more comfortably, offered my arm for support when Mom climbed stairs, or pulled her up if she were on a low seat or the floor. This continued through college, until I moved out. I was 25 then; Mom was 59.

How much of her back and leg pain was due to injuries and arthritis, and how much was due to muscles that weren’t strong enough to work effectively?  I don’t know. I do think she had a reinforcing negative spiral: she exercised less because she felt out of shape; she became more out of shape because she exercised less.

I do know that I developed a self-image of myself as strong and capable due to spending my teen years in my self-appointed role as Mom’s caretaker.  I know that part of why I was frightened by injuring my knee was “I don’t have mobility problems, Mom does“.    And I know that one of my motivations to exercise is because it may not let me avoid my mother’s problems — but I’m fairly sure that NOT exercising would make me repeat them.

*Southern accents weren’t exactly “in” during the 70s in Seattle. One speech therapist blamed my lisp on Mom’s tendency to add “r”s to things like “warsh” and “Warshington”. Funny how Mom didn’t have a lisp, and mine went away with orthodontia and practice.

Is it fat or lack of exercise?

Lately I’ve felt like the “Maybe you want to exercise?” fairy.  People muse about aches, lack of energy,  difficulty walking, and wonder if it’s weight or just aging….

And I pop in with, “Are you sure it’s not lack of exercise?”

Please understand, I’m not actually trying to make people crazy.   See, I’ve weighed over 350lbs for over 15 years.  During that time:

  • I’ve been in very poor physical condition, which for me means walking a block or carrying groceries is difficult.  This included several months of constant pain in one leg or the other.
  • I’ve also been in pretty good physical condition, meaning that walking 2 or 3 miles or carrying boxes of books is easy.

Note that what doesn’t change overly much between these two states is my weight.*  What does change is how active I am and whether I’m getting regular exercise.   It’s almost like muscles usually get stronger from exercise, or like exercise doesn’t require weight loss to improve health.

I’m not trying to be unsympathetic. I have been at the point where I was in constant pain, such as when I injured myself by starting an exercise program that I thought was moderate and reasonable.  (Really!  It just, um, turned out not to be moderate and reasonable enough.)   I did physical therapy, now it doesn’t hurt … as long as I keep up with my exercises.  This has become one of my huge motivators to exercise: not hurting.

I used to get more activity in my daily life, either walking around school or chasing 4-year-olds or walking around the huge office park where I worked.  I would feel stronger and more energetic and just better when I was exercising regularly, but even when I wasn’t I wasn’t as sedentary as my life allows now.  I don’t get what I consider to be enough activity from my daily life, so I exercise.

I do truly believe that fitness isn’t a “yes” or “no”.  It’s a question — fit for what? It’s partly a function of where your body is now (A), what you want to be able to do (B), and what’s involved in getting from A to B.   Sometimes it’s not doable, either because of disability, time commitment, or lack of equipment (if you want to be able to swim 2 miles and don’t have access to a pool, you’re going to have problems!)

My goals?

  • I want to be able to walk a few flights of stairs, to be able to walk a few miles, and to be able to lift and carry 50 or 80lbs a few dozen yards.
  • I want to be able to balance on one foot for 30 seconds or more.
  • I’m happy with my current level of flexibility, so I want to maintain it.

What am I doing about it?

  • I’m going for a walk every day.  Short, but daily, and increasing as I feel capable.
  • I live in a house with stairs and I sometimes take the stairs at work.
  • When I take the elevator, I balance on one foot while waiting for it.
  • I continue to stretch and do yoga at home.

This doesn’t mean I think everyone has to exercise.  Just that I find it helpful for my own energy and ability levels to focus on exercise.

*I have gained and lost weight in there — most of the gain was during a bout with depression, with a bit of help from Celexa.  For me, exercising regularly tends to result in a 5 to 10lb weight loss.  I also lost 30lbs on Atkins before I began regaining; final result was a net gain of 10lbs.

Very Obese Adults Almost Completely Sedentary?

For all the freaking out in the media about the obesity crisis, there’s not much research on folks who are very fat.  So a study on folks with an average BMI of 53 shows some promise…right?

Sorry.  The headline: “Very Obese Adults Almost Completely Sedentary“.  I’m not sure how many people are going to read beyond that, but if they do, here’s what they’ll find:

  1. Only 10 participants.
  2. Comparing the study’s assertion that morbidly obese people “average less than 2,500 steps per day” to the “healthy living guidelines of 10,000 steps per day” and not the actual average of, say, a control group.
  3. “The study used a precise body sensor to continually measure physical activity, caloric expenditure and movement minute-by-minute over a 72-hour period within their home environments.”   I may be misreading this, but it seems telling that this is not “during their normal daily routine” but “within their home environment”.   My job is fairly sedentary, but I still walk more at the office than at home because the office is more spread out.   I also don’t go for a walk in my living room.  I walk around the neighborhood, or at a park, or a mall, or I use the gym’s treadmill.
  4. I don’t know how accurate pedometers are for large people in general.  I personally have tried two and found they weren’t accurate at all using the basic “walk down the hall wearing the pedometer and counting my steps” test.  I counted 20 steps each time I walked down the hall; the first pedometer came up with 10 one time, 35 the next, 8 the time after that.   The second one was similar.  I didn’t exactly find this encouraging.

Now, I don’t think this research is a bad idea.  I think it would be a good idea to look at this, not just with “morbidly obese” but also with “normal weight” and “overweight” too – using representative samples and trying to approximate normal routines.    But from what’s been made available about this study, I don’t think it’s going to add a lot of useful information.

There’s an update on this here.

Fit or Not Fit

This came in as a comment to one of the “Day in the life” posts.

One movement involves leaning forward; this irritates my lower back so I substitute something else.
Jesus! You’re practically crippled by your weight. A normal person would be able to do this easily.

It”s enough of a workout to get my heart into the aerobic range
If a bit of shuffling around gets your heart rate into the aerobic range, you are seriously, seriously unfit.

Don’t kid yourself that moving around and breathing hard constitutes exercise.

Getting past the fact that my lower back is stronger than it has since I initially cracked my tailbone in 7th grade and that aerobic exercise IS whatever gets your pulse into a particular range, this does bring up one point I thought worth talking about.

That is: I don’t claim to be especially fit.   I don’t think I AM fit. There’s quite a few reasons for this.

Continue reading

Being Fat and Fit

I found this on an “expert q&a” on exercise on the New York Times site with Steven Blair, an exercise researcher and former president of the American College of Sports Medicine.

Can someone be fat and fit? Yes.  We began in 1995 to look at fitness and fatness as predictors of mortality, separately and together. What we found then, and continue to find in ongoing studies, is that people who are fat — whether measured by body mass index, or a more direct measure of body composition such as skin fold or underwater weighing – and are also fit do not have a substantially elevated risk of mortality. In fact, they have a much lower mortality risk compared with lower- or normal-weight individuals who are sedentary.


I think those of us involved in public health have to stop carrying on at such great length about how bad obesity is; that strategy simply is not working. We need to focus instead on behaviors that lead to good health: eating more fruits, vegetables and whole grains; keeping fat and alcohol intake to a minimum; and accumulating 30 minutes of walking on at least five days per week.

If everyone did that, they’d be healthier. If the 40 to 50 million adults who do essentially no physical activity would just get up and move around — not worrying about their speed but moving along at a comfortable pace — they would feel better and start getting health benefits. But make no mistake: we’d still have short fat bald guys like me. I’m never going to be a movie star or play basketball. But I’m controlling what is under my control – namely, my habits. So I do follow my own advice.

Note: Fat Acceptance does not require that fat people meet some “healthy” standard. Fat people can be healthy OR unhealthy, just as thin people can be healthy or unhealthy.