Lifestyle Assessment: Exercise and ActivitySaturday, September 17, 2011
Today’s post is another excerpt from “Best Weight: A Practical Guide to Office-Based Weight Management“, recently published by the Canadian Obesity Network.
This guide is meant for health professionals dealing with obese clients and is NOT a self-management tool or weight-loss program. However, I assume that even general readers may find some of this material of interest.
EXERCISE AND ACTIVITY
Exercise is an important determinant of health, and has beneficial effects on aerobic fitness, insulin sensitivity, blood pressure and coronary heart disease risk reduction, regardless of a patient’s weight. It is also an important factor in weight management.
Asking patients about the type and amount of physical activity they undertake on a daily basis provides clues about the amount of energy they expend. It is important to explore types of activity undertaken at work and during leisure time. Patients may describe themselves as extremely busy and active at work, but careful questioning may reveal that they are in fact running to and from the car, to and from the elevator, and to and from their desk. While busy, they are not really physically active at levels sufficient to elicit an exercise response.
Different occupations involve different levels of activity, but in our day and age, it is exceedingly rare for a patient to be very physically active at work. Even occupations that were traditionally quite strenuous, such as farming, have incorporated labour- and time-saving devices that increase productivity while diminishing the farmer’s expenditure of physical energy.
One way to obtain an objective measurement of activity is using a pedometer. Patients may talk of targeting 10,000 steps in their weight-management program, but a target set too far above what the patient is accustomed to is much less likely to be met. Establish a baseline and work from there to gradually increase activity levels.
Patients will often complain they do not have time for physical activity. It is important to explain that, from a weight-management perspective, exercise is cumulative and they do not need to find an hour every day to devote exclusively to physical fitness. Every 10 minutes of exercise counts, and virtually everything counts as exercise: walking, gardening, house work, playing with children, etc. Only a small minority of patients can motivate themselves to visit a gym on a regular basis, but most can find multiple 10-minute blocks of increased activity a day.
If patients have exercise equipment in their homes, encourage them to move the treadmill or stationary bicycle from the basement to the living room where it can better assert its existence.
Patients can be taught to establish cues that will help them remember to exercise. For example, to watch a favourite television program, they must be at least walking on the treadmill. Reward systems work too: for every ‘x’ minutes of exercise, the patient allows him- or herself some form of non-food-based reward.
Explain to patients that the calories they burn through exercise on a daily basis are not significant enough to warrant extra foods or increased portion sizes. People dramatically overestimate the calories burned through exercise, so remind them that the calories burned in 30 minutes of intense exercise can be consumed in 30 seconds with an increased portion size or a simple chocolate bar. However, over time, exercise can have a dramatic impact on weight and can greatly reduce the risk of regaining lost weight.
© Copyright 2010 by Dr. Arya M. Sharma and Dr. Yoni Freedhoff. All rights reserved.
The opinions in this book are those of the authors and do not represent those of the Canadian Obesity Network.
Members of the Canadian Obesity Network can download Best Weight for free.