Many people with chronic health conditions are told by their doctor to “lose weight”. Having a chronic condition can mean the weight creeps on, often prior to diagnosis when we don’t know what is wrong, just that we aren’t well. This may continue after we are diagnosed, while we wait for treatment decisions to be made or for treatment to kick in. We may be on a steroid for a while (as I was) which despite the best intentions in the world can result in patients gaining unwanted kilos. Lots of stuff going on that disrupts our normal patterns, can effect our ability to see we are gaining a kilo or two.
How many times do any of us get home from work too tired to cook a proper meal, so we have a toasted cheese sandwich? With Vegemite, of course! Or grab take-away on the way home? Maybe even Vita-wheat, Vegemite and cheese. That’s 232 calories, but not really nutritionally balanced. Doesn’t look too appealing either, to be honest.
In addition, because we don’t feel well, we aren’t exercising enough to compensate for our often less than optimal food choices. We are defeating ourselves from both aspects: too much in, not enough out. We are NOT necessarily able to just ramp up our weights or cardio and burn that cheese sandwich right off. In fact, walking from the car to the lift at work may be as much as we can manage some days. Adjusting to our new activity levels means adjusting to new fuel levels as well.
I can see some readers rolling their eyes already: “I knew she’d get to the weight loss eventually, but I want a coach who isn’t all about the scales“. Hear me out. Let me assure you I am not all about the scales (actually, I am all about food scales), but I mostly certainly AM about helping my clients attain and maintain a weight that supports their efforts to manage their condition – or conditions. Take a good honest look at my picture below – do I really look like Vogue are going to invite me to appear on their cover next month? Of course not – I am no Australian size 6 – nor do I aspire to be. That photo is 12 months old – taken shortly after my medication change but before I was able to ramp up my own weights, but I have used it deliberately to illustrate the challenge we face.
What I aspire to is being pain free and in control of my conditions. I’ve achieved that as far as my autoimmune conditions are concerned, but I can still improve my back support (detail later in this article). I am not going to complain if I lose a few more kilograms, but neither am I going to obsess about it. While the lighter I am the less stress there is on my joints, where I am right now I’m more interested in building strength (to support my joints and increase my metabolism (in turn encouraging those kilos to drop off as a nice side benefit).
Make no mistake, when it comes to your health, the risk of developing a range of conditions is dramatically increased if you are overweight or obese (comorbidities associated with obesity are conditions such as diabetes, heart disease and cancer to name just three) . The risk of negative long term health outcomes are higher if you remain overweight or obese. The medical and scientific evidence is overwhelming.
Being overweight increases the load on joints for conditions such as the arthritis family. The heart has to work harder to pump blood around. If you find doing stuff an effort, imagine how hard your internal organs are working. My lumbar spine is not a lumbar spine I would recommend either – as we get older, lots of bits and pieces tend to show wear and tear, irrespective of any conditions we may have. In my case my lumbar spine is a bit unhappy. So core and glute strength is important for me.
At L3/L4 I have “marked facet joint hypertrophy” and a disc bulge. At L4/L5 I have a broad-based disc herniation and facet joint arthropathy. The complete findings run a full page, that’s just a sample. I don’t need or want to place any more stress on my back by making it carry around extra kilograms or not supporting it with good muscle tone. I still have some intermittent pain we suspect may be the result of this wear and tear, but it is improving.
To give your body the best chance of serving you well for the next 20, 30 or 40 years, you need to take care of it. Especially now a medical condition/(s) is making a darn fine effort at undermining your plans. Reduce the strain on the joints, give your heart and lungs a lighter workload, give your body the right fuel in the right amounts.
Speaking of fuel, when you take your car to fill up the tank with petrol or diesel, the fuel tank has a finite capacity. My car has a 60 litre tank. I can’t put 70 litres in the car. Our bodies are a little more flexible. My body will use an estimated 1,388 calories a day to stay alive: breath, pump blood around, blink (refer BMR Calculator below this article). I’m 62, so my metabolism is already slowed just by the fact I’m not longer 20. If I eat more than 1,388 plus whatever my activity calorie burn is but don’t use it, I’ll just expand. Unlike the car’s fuel tank, my body has no capacity limitations. Nor does yours.
Example: 1,388 + 100 for steps for day + 380 for a strength workout = Total 1,868
If I eat 2,200 calories, guess where the excess over 1,868 is going? Fat stores. That puts more stress on my joints, internal organs have to work harder.
Many of the learned articles on overweight/obesity talk in financial terms of the costs to the community and the country. I’m concerned about the personal non-financial costs to YOU, the individual.
I won’t lie to you. Getting into the groove of eating less calories BECAUSE you are burning less calories is a bit tough initially. As I mentioned in my opening paragraph, it may be a while before you even realise your activity levels have dropped or your metabolism may have slowed as a result of your new friend, your condition. We have to adjust to not burning as much as we used to: it requires us to develop new habits, change behaviours: that is hard. But only for the first few weeks. What bothers you more? A difficult few weeks – or a tough (possibly shortened) rest of your life? The sooner you take positive action, the shorter the road will be.
Am I saying I never have a Murray River Salted Caramel with Macadamia ice cream (my nemesis)?
No, I’m not saying that. I like to have the things I really enjoy every now and then. I am also well aware that “little” indulgence is worth 339 calories. In other words, worth a whole meal (for my calorie levels, you may be able to have more). If I’ve burnt off 400 calories through activity that day, I can indulge and still hit my calorie deficit target. If I’m having a day where for whatever reason I’ve done very little activity, I make sure I am strict with myself. Keep on top of it, because we no longer have the luxury of going for a 40 kilometre bike ride to pull back a couple of naughty days.
All that discussion was without even looking at ensuring we are getting balanced nutrition. Our body is fighting an internal battle for us now – we need to give it the right nutrients (micro and macro) to put up the best fight it can. That’s a whole different topic for another day!
This article should be read as an introduction and conversation starter only. The concepts discussed are general and not tailored for any individual circumstances. Limberation can provide healthy eating support and guidance.
PwC report, Weighing the Cost of Obesity
BMR Calculator mydr.com.au
BMI Calculator mydr.com.au
Also check the references on the Science Stuff page.