Losing Weight When You Physically Can’t Exercise: Doreen’s Journey

Doreen Gee has enjoyed walking her entire life. Even into her 50s, she took almost daily jaunts in her hometown of Victoria, British Columbia. But everything changed as she approached 60. Severe osteoarthritis in both knees affected her quality of life, her relationship to her body and, especially, her weight.

By her 62nd birthday three years ago, she found herself 60 pounds overweight and in near-constant excruciating pain. The only way forward was dual knee replacements. Gee realized she needed to make a change.

The simple solution was that the closer she could get to her ideal weight before surgery, the better the potential outcome of her knee replacements would be. The easy answer was changing her diet — if only it were easy. She admits she was “not into dieting,” but the time had come to take it seriously. She first learned about MyFitnessPal by way of the Arthritis Society, a Canadian nonprofit organization devoted to patient education.

When she started tracking her calories and exercise, she couldn’t even walk a block due to severe pain in her knees. Within weeks of sticking to a restricted-calorie diet, she shed some of the weight and felt better physically — and more motivated psychologically — almost immediately. Steadily, she began losing 1–2 pounds per week.

Her real revelation, however, came when she began the practice of recording her food intake every day, which she describes as a learning experience. “I thought I was eating healthful foods, and I was, in part,” she says. “But in recording my intake, I woke up to how many calories I was consuming, especially in healthful foods like nuts and cheese, but in quantities too large for my optimal daily intake of 1,200 calories.”

For the remainder of 2014, she diligently followed the program and became instinctively aware of what foods were best for her body and for weight loss. “Recording my meals helped me stay accountable,” she says. “It works like clockwork. If you stick to the program, the weight comes off. It’s that simple.”

When she consulted with her surgeon ahead of her first knee replacement, their conversation helped her begin to realize just how much weight is tied to overall health — more specifically, how obesity is linked to poor health. She got the message. By the time she had her first knee replacement surgery in July 2015, she had shed 30 pounds. Daily exercise and physiotherapy were crucial to her successful recovery, and she found them more manageable after losing weight. But she still wasn’t able to walk very far because she needed a second knee replacement.

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But then came the challenge of the second surgery in January 2016. Her recovery was more intense, which made her rehabilitation process more arduous. So did her day job: As a freelance writer, Gee spends most of her work hours sedentary. That didn’t help her bounce back physically (though plunging back into her work helped her mentally). By last October, she had gained back the weight she had lost and was virtually unable to exercise again.

Recommitting to the same weight-loss plan required more work, but Gee took the plunge: It’s the only process that had ever worked for her, she says. She quickly realized the discomfort in one of her new knees eased when she lost weight, and she was tired of her weight draining her of energy. So she began again. After her recovery from her second surgery, she was able to start exercising more immediately, which further bolstered her spirits. She began with brief walks down the block and increased her time and distance daily. Within a few weeks, as her knee healed, she was walking for pleasure daily.

Today, she has since lost 20 pounds, is down a pants size and is able to walk to her local rec center for Zumba classes regularly. She thinks of her new knees as “deserving less weight on them — the miracle for me is to be able to walk again.”

What she likes best about integrating MyFitnessPal into her life is that it focuses on balance, not deprivation. She has been able to decrease her intake of sugary, nutrient-poor foods while increasing protein and fiber and rebuilding her physical stamina.

Now, at 65, she feels like she’s regained her health in many ways. “Life is already better because I’ve lost the weight,” she says. “I plan to stay healthy for as long as I can.”

How to Avoid Gaining Weight When You’re Injured

Does an injury have you sidelined from your regular workout routine? Don’t sweat it. While getting injured can be frustrating (and painful), it doesn’t have to mean you’ll gain weight. In fact, it may be a great time to take a break from your current workout and focus on other ways to stay fit. And the good news is, when your body is ready to go back to your workout routine, it will have to work even harder than it did before, making it even more effective.

In the meantime, here are three ways to avoid gaining weight while you recover:

1. Look for alternative methods of exercise.

Can’t run on your injured knee? This might be a great time to try Pilates instead with a qualified instructor or a physical therapist, says Lisa Hubbard, founder of Rhythm Pilates™ and star of the Element: Total Body Pilates with Mini Ball DVD. “Many physical therapists use Pilates to assist in the increased range of motion of a joint, tissue and musculature repair, to help bring awareness to your body, and to assist in regaining strength and flexibility.”

If your injury isn’t too severe, you may be able to replace pounding the pavement with lower impact forms of cardio such as cycling or swimming. Being sidelined from your regular workout routine may not be a bad thing – it could give you the extra motivation you need to try something new or kick up your strength training while you heal. Just be sure to talk with your doctor or physical therapist (if applicable) first to find out exactly what kind of activity you should and shouldn’t be doing with your specific injury.

2. Start a new, healthy habit.

If there’s nothing physical you can do while you recover from your injury, focus instead on starting new, healthy practices like eating or sleeping better. Hubbard suggests dedicating the time you may have spent running to creating other healthy habits than can help with weight loss or maintenance like eating raw food. Try out a few new recipes or experiment with adding in more raw foods to your current meals. “Eating raw food will inevitably keep weight down during recovery, and you may even lose a few pounds,” Hubbard says.

Your recovery time may also be the perfect opportunity to make sure you’re getting enough sleep. Getting in enough hours of quality sleep while you heal could be as important for weight loss as your calorie burning, so make sure you’re logging between 7 to 8 hours of shut eye every night.

3. Help someone else.

An injury can often turn into an excuse to wallow in self-pity on the couch with a bag of chips. Instead, why not reach out and help someone who might be much worse off than you are? Donating your time, service, or even just visiting with someone can help take your mind off of your situation and may be even more rewarding than a workout could ever be, Hubbard says. “I am a true believer of giving to others, whether to charities, or to service of others-it can be so rewarding, satisfying, and fulfilling that it may eliminate your desire to visit the kitchen too often.”

Finally, don’t forget the gym isn’t the only place to burn calories. The more active you can be throughout your daily life, the better (even if it takes a lot more effort to get around). Use this time to heal, take good care of yourself (follow doctor’s orders) and others, and you could even end up losing weight!

  • By Jessica Smith

RELATED: The 5 Best Apps For Weight Loss, According To Experts

“I Got A Diagnosis”

Christa

Sometimes a sudden weight gain or inability to lose weight isn’t from overindulging on pizza and cake but from a medical cause. Such was the case for Christa H., of Denver, Colorado. “Several years ago I rapidly gained about 20 pounds, it was horrible,” she says. “I suffered for months trying to lose weight before deciding to see my doctor. It turns out I have Hashimoto’s, a thyroid disease.” The illness lowered her thyroid function which explained the weight gain. After getting on the proper medications to manage it, she’s been able to slowly lose the weight. She’s done this by counting calories and making healthier choices, but due to a busy job and the effects of the Hashimoto’s on her energy levels she hasn’t been able to exercise much. “It’s taken me a year and a half of treatment, patience, and trying to treat my body right, but it’s worth it because I feel so much better,” she says.

What the experts say: “There are many medical factors that influence weight gain and weight loss, such as sex hormones, liver function, insulin, gut bacteria, and, yes, thyroid function,” Ziltzer says. Talk to your doc if you suspect an underlying health concern.

(Tone and tighten your entire body with Women’s Health’s Guide to Strength Training!)

“I Cut Carbohydrates”

Emma P.

Low-carb diets are having a serious moment, but for Emma P., of Austin, Texas, they didn’t go quite far enough. In November of this year she decided to go “full keto” (meaning ketogenic, the process by which the body uses stored fat for energy instead of glycogen). “My diet consists mostly of fat, with some protein, and I aim to eat close to zero carbs per day,” she says. “I really don’t exercise, and its typical for keto people to not need to exercise for weight control. I try to stay active, but I don’t go out of my way to work out.” While it may sound extreme to some, she’s seen amazing results, losing 40 pounds in a year, and 10 pounds the first month.

What the experts say: While Ziltzer doesn’t necessarily advise cutting out all carbs, recent research published in the journal Diabetes & Metabolic Syndrome: Clinical Research & Reviews does show that the keto diet might burn 10 times more fat than other diets.

Check out some of the weirdest weight-loss trends through history:

“I Track My Calories With An App”

Megan H.

When Megan H., of Ridgecrest, California, first started trying to lose weight, she did it by hiring a personal trainer. While she did learn a lot about working out, she says it didn’t help with weight loss: “I’d go home from workouts absolutely starving and then eat more than what I’d burned at the gym.” So she turned to tracking her calories using the MyFitnessPal app. This helped her start losing weight steadily, culminating in a 40-pound weight loss over the past 18 months, despite being out of the gym and unable to workout since April, due to a health condition.

What the experts say: “Weight loss requires getting complete nutrition with fewer calories than you burn,” Ziltzer says. While you can create a caloric deficit with exercise, you can also achieve it through cutting calories. And since most women have little to no idea how many calories they eat per day, tracking is a great place to start.

RELATED: This Is Exactly What 5 Personal Trainers Eat For Breakfast

“I Eat Whole Foods”

Shannon L.

Shannon L., of Denver, Colorado, dropped 15 pounds in five weeks by emphasizing eating whole, unprocessed foods. “For me, it’s all about eating real food; proteins, whole grains, fruits, vegetables and I save 100 to 200 calories per day for a treat so I don’t feel deprived,” she says. “I’m a proponent of regular exercise, but due to some major life changes, I’ve gotten out of the habit. Yet my weight loss has still been successful without exercising.”

What the experts say: Focusing on whole foods is an incredibly simple way to automatically cut calories while also increasing your vitamin and mineral intake, both of which can help support healthy weight loss, Ziltzer says. “Diets high in processed carbs will lead to weight gain, while diets high in fiber and protein will contribute to weight loss,” he says. “Stick to proteins such as chicken, lean meats, fish and shellfish, and lots of veggies in order to see maximum results.”

This picture has absolutely nothing to do with today’s article.

I just love Homer, and I wanted to get your attention…although you might be eating a doughnut right now as you read this.

Let’s hope not.

Before I start, I want to let you know I’m not condoning zero exercise. But I’ll tell you that one of our best success stories, Tim, got injured and “couldn’t exercise” for six months.

And yet…he still lost 50 pounds:

Look, the RIGHT kind of exercise is freaking awesome and something you should try to do every day.

However, I am here to tell you that if your primary concern is weight loss, exercise is merely the icing on the cake. Or, the bacon wrapped around the asparagus, to be healthier.

90% of your waistline battle is won or lost in the kitchen (or at the restaurant table, or at the drive-thru window, etc.)

Warning: this will ask you to possibly make some substantial changes to your diet – are you up for it?

If you’ve struggled to change your diet in the past, or you’re stick of starting and stopping a diet, I’m here to tell ya you can stop starving yourself and getting frustrated. We’ve helped tens of thousands of busy people change their diets, like Tim above.

It starts by having an actual plan of attack and following it! We know everybody is at a different point in their life, so we created a 10-Level Nerd Fitness Diet that allows you to slowly change your nutritional strategy over time so you can have permanent success.

Grab our NF Diet Strategy Guide free when you sign up in the box below, and then get back to learning about how important your diet is!

Download our free weight loss guide THE NERD FITNESS DIET: 10 Levels to Change Your Life

  • Follow our 10-level nutrition system at your own pace
  • What you need to know about weight loss and healthy eating
  • 3 Simple rules we follow every day to stay on target

Eat Real Food

I’m a huge fan of the food philosophy presented in books like The Paleo Diet and Good Calories Bad Calories.

Because they make this diet thing so simple and logical even a caveman could understand it. My apologies if you’re a caveman.

If you’re new to the “Paleo Diet” concept, here it is in a nutshell. Rather than list what you can’t eat, here’s what you CAN eat:

REAL foods – veggies, lean meats, fish, eggs, fruit, and nuts.

Why does this work? Because you’re only eating foods that you’re genetically engineered to thrive on: high quality, high energy REAL foods. Not from a box, not from a bag, not from a window. Food from the earth. Yay nature.

We’ve written a 4,000-word monster article on the Paleo Diet that’s a must read if you’re going to start eating healthier, but I know this stuff can be overwhelming. We consider the Paleo Diet fairly difficult to stick with, which is why it’s one of the higher difficulty levels on the Nerd Fitness Diet.

Grab our strategy guide (sign up in the box below) along with a free guide on the Paleo Diet too so you can pick a level that doesn’t scare you first, and then slowly ramp up to it:

Download our free weight loss guide THE NERD FITNESS DIET: 10 Levels to Change Your Life

  • Follow our 10-level nutrition system at your own pace
  • What you need to know about weight loss and healthy eating
  • 3 Simple rules we follow every day to stay on target

Cut Way Back on the Rest

Bread, cereal, pasta, fried food, rice, bagels, doughnuts, waffles, chips, tortillas, candy etc. – these things are all loaded with carbs (and if they’re processed – refined carbs and sugar), and I’ll bet a million Monopoly dollars they’re the cause of 99% of the population’s weight problem.

I’m not telling you to give all of this stuff up completely, I’m just telling you that this is probably the reason the weight isn’t coming off of your frame.

Here’s why:

Most grains, refined carbs and sugar were nonexistent way back in the day, which means our bodies never quite adapted to properly process them. They can wreak havoc on our gut, cause our insulin to spike and can lead to weight gain.

Here’s a great video to explain why refined carbs make you fat:

Today’s general recommended diet ratio of 50-60% carbs, 30% protein, 10-20% fat is quite far off from where your nutrition should ACTUALLY be.

This ratio has been pushed on the public for decades, and new “low fat” items continue to pop up every day…and yet the country continues to get wider and bigger and fatter.

Something’s not right.

How I Know it Works

Although I’ve recently added some grains back into my diet to bulk up (oats, flaxseed bread, and brown rice), I can attest to the fact that the Paleo Diet absolutely works.

In the four months that I switched to a Paleo diet (my ratio was probably 40% fat, 40% protein, and 20% carbs), my body fat percentage dropped from 12% down to 5%.

Besides myself, many NF readers have lost quite a bit of weight from making this change as well.

Guys like Saint who went full Paleo:

And women like Staci who also went full Paleo and started strength training:

Cut Out Liquid Calories

Soda, beer, juice, margaritas Gatorade, vitamin water, cappuccinos, fruit coolatas – avoid them whenever possible (except for beer on St. Patty’s Day…come on.)

These beverages are all loaded with sugar which immediately turn to fat in your system. And switching from a 12 pack of Coke to a 12 pack of Diet Coke might not solve your problems either.

Read my article why Diet Coke might make you fat, and our overall thoughts on Alcohol too

My advice: chug water like it’s your job, stick to black coffee, cut out liquid calories.

It will curb your appetite, keep your insides running properly, and give you an excuse to get up and go for a walk to the bathroom every thirty minutes.

No Paleo? No Problem. Eat Less Than Before!

Don’t want to change what you eat? Welp, you’re just going to count calories, and work on portion control.

It’s a pain in the ass, but it works – though tough to maintain over many years.

Here are the three equations you need to know:

  • Calories consumed > Calories burned = weight gain.
  • Calories consumed < Calories burned = weight loss.
  • 3500 less calories per week = 1 pound of fat weight loss.

As explained in the video above about “Why you got fat”, the types of you food you eat is more important than these equations let on, but just creating a caloric deficit will still produce weight loss (although far less efficiently).

The challenges most people run into is that they eat poorly, and then expect a bit of exercise to make everything better! The reality is, eating poorly could mean you’d need to spend HOURS burning calories just to not gain any weight.

I just don’t have that kind of free time and I’d guess that you don’t either, so why not work smarter instead of harder, right?

Remember Tim above? He followed the nutritional strategy in our flagship course, The Nerd Fitness Academy and just went for a walk each day.

Because he really bought into the idea that “Nutrition is 90% of the battle,” he put his focus there, and lost 50 pounds in 6 months in the process:

So, work smarter, not harder, like Tim.

Rather than eating bad foods and spending hours working it off, instead eat GOOD foods, only do exercise that’s fun for you (hiking, playing with your kids, biking, yoga), and then enjoy the rest of your day.

Life’s too short to spend it doing stuff that’s just not necessary. But you DO need to fix your diet. If you are overwhelmed already with the idea of changing how you eat, counting calories, and how you can make progress in a way that doesn’t scare you.

Grab our 10-Level NF Diet Strategy Guide, pick the level you want to start with, and treat each level like a challenge you have to complete before leveling up. And you’ll lose weight and get healthier as a side effect – not too shabby.

Download our free weight loss guide THE NERD FITNESS DIET: 10 Levels to Change Your Life

  • Follow our 10-level nutrition system at your own pace
  • What you need to know about weight loss and healthy eating
  • 3 Simple rules we follow every day to stay on target

The Choice Is Yours

I’m not going to yell at you and force you to only eat grilled chicken and steamed vegetables for every meal – I’m not your mom (phew, that would be weird). Besides, you’re a grown individual and you can make choices for yourself.

I AM, however, telling you that if you want to see results without spending hours upon hours in the gym, you need to get your diet under control, and this is the most efficient way for you to get there.

The more you can change to what’s been listed above, the quicker you’ll get to your goal weight.

Switching to a 100% Paleo Diet after years of eating bad carbs is a recipe for disaster and you giving up immediately! Instead, try finding a way to implement a change or two along the way until you start to see those results.

I realize this is much easier said than done, which means this isn’t really about your diet: it’s about your willpower and finding a good balance of changes that you can successfully manage.

Whenever somebody says “I can’t give up that food” or “I just don’t have time to prepare a healthy meal” all I hear is, “I don’t want it badly enough yet.”

I’m okay with that!

We all start somewhere, and we are all afraid of change deep down – it’s in our DNA. So let’s start with small changes.

Start at Level 1 of the Nerd Fitness Diet, and work your way up when you’re ready – no change should be one that’s too far outside of your comfort zone. Grab our 10-level guide when you join the rebellion in the box below:

Download our free weight loss guide THE NERD FITNESS DIET: 10 Levels to Change Your Life

  • Follow our 10-level nutrition system at your own pace
  • What you need to know about weight loss and healthy eating
  • 3 Simple rules we follow every day to stay on target

If you’re not at that point yet to take control of your life, I’ll do my best to inspire and motivate you to get there…but the desire to change has to come from within you.

If you ARE at the point where you really want to make a change, I’m here to help, along with a community of people on our message boards who are there to support you.

Do we have any Paleo Dieters here? How did you successfully make the transition from a modern diet to a healthy one?

Do you have concerns about giving up carbs and eating more fat? I’m only writing from experience and my own research, but would love to hear some stories on your weight loss successes or failures and I know others would too.

Let’s hear it!

-Steve

photo: Greg Easton Photography

A Prescription for Weight Gain?

It’s not only medical conditions that can add pounds. Some medications can also cause you to gain weight, or keep you from losing it, says Ken Fujioka, MD, medical director of the Scripps Clinic Nutrition and Metabolism Research Center in San Diego.

“It’s very common for medications to cause weight gain,” says Fujioka, noting that approximately 25% of his patients are on medication or have an illness that is causing them to gain weight.

Among the medications that may cause weight gain in some people are:

  • Medications used to treat type 2 diabetes (such as sulfonylureas)
  • Antipsychotic or schizophrenia medications, including chlorpromazine (such as Thorazine), thioridazine (Mellaril), and olanzapine (Zyprexa)
  • Beta-blockers (prescribed for high blood pressure, and some heart conditions)
  • Antidepressants such as amitriptyline (Elavil), imipramine (Norpramin), or trazodone (Desyrel)
  • Hormone replacement therapy
  • Birth control pills
  • Corticosteroids taken for conditions like asthma and lupus
  • Antiepileptics taken to control seizures, especially valproic acid (Depakene or Depakote) and carbamazepine (such as Tegretol)

The reasons certain medications cause weight gain can vary and are not always known, says Fujioka.

Antipsychotic drugs, for example, may increase appetite as well as lower the metabolic rate (the rate at which your body burns calories). Beta-blockers are thought to lower a person’s metabolic rate by about 80 calories a day. And hormone replacement therapy increases the body’s level of estrogen, a fat-storing hormone.

“Weight gain is a very troublesome — and unpredictable — side effect of certain medications,” says Arthur Frank, MD, director of the George Washington University Weight Management Program. “You can experience a substantial weight gain if you’re sensitive to that particular medication.”

But if you’re gaining weight on one medication, your doctor may be able to help you find a similar drug that won’t have the same effect. For example, an older class of antidepressants known as tricyclics may cause weight gain, while a newer class of depression medication called SSRIs (selective serotonin reuptake inhibitors) usually doesn’t, says Fujioka. SSRIs include Celexa, Lexapro, Prozac, Paxil, and Zoloft.

Medications cause weight gain in both men and women, but because women gain weight more easily than men in general, and have a harder time losing it, they may notice more added pounds than men taking the same medication.

After surgery, your body requires a higher amount of energy and protein for the healing process.

For this reason it is not an ideal time to attempt to lose weight. It is more important to focus on weight maintenance because a lack of proper nutrition can cause dehydration and an inability to heal properly. You will likely be less active in the few weeks following your surgery, making weight maintenance more challenging. Here are some tips to help you eat well and avoid weight gain:

1. Small, frequent meals. Various pain medication or antibiotics prescribed after surgery, can cause an upset stomach or decrease an appetite. Should you experience these side effects, it is important to make sure you maintain adequate nutrition for healing. Having small, frequent meals or snacks instead of 3 large meals per day is a great way to help meet your nutritional needs after surgery, and can also help to avoid weight gain. Aim for your total caloric intake to be distributed throughout the day, with the consumption of 4 to 5 small meals or snacks daily. An example of a small meal may be a turkey sandwich on whole wheat bread with a cup of broth-based soup. A small snack may be an apple with 1-2 tablespoons of natural nut butter.

2. Focus on lean protein. Protein plays a vital role in tissue repair and healing, growth, maintenance and energy. After surgery, remember to incorporate some form of protein at every meal or snack. To avoid gaining weight, concentrate on lean or low-fat protein sources such as skin-less white-meat poultry, lean cuts of beef or pork, fish, eggs, low fat dairy products, nuts, beans and legumes. Baked, broiled, steamed, roasted and grilled meats are preferred over frying or sauteing to avoid excess calorie intake. Avoid heavy sauces and gravies, when possible.

3. Eat more vegetables. Research has shown that individuals who eat more vegetables tend to avoid gaining weight. This is due to the high water and fiber content of vegetables, which helps us with satiety. Including a variety of vegetables in your post-operative diet will insure that you get the essential vitamins and minerals for healing while also helping to stave off weight gain. Great choices include: spinach, broccoli, cauliflower, tomatoes, peppers, mushrooms and artichokes, just to name a few. If you are sent home on the blood thinner Coumadin, it is important to limit your consumption of green, leafy vegetables, such as spinach, kale and broccoli to about 1 cup per day.* Other vegetables such as peppers, tomatoes, cucumbers, iceberg lettuce, celery and carrots have very little Vitamin K and can be eaten more liberally.

Note: *These vegetables are high in vitamin K and can interfere with the function of this medication. If you are to be sent home on Coumadin, be sure to discuss this with your doctor and dietitian, prior to discharge.

4. Fiber. Often, a common side effect of pain medication is constipation. Additionally, you will likely be a lot less active than usual, post-op, potentially exacerbating this side effect. Consuming a diet high in fiber can help prevent or relieve constipation, helping to maintain normal bowel function and a healthy weight. Examples of high fiber foods include: bran cereals, cooked beans, whole fruits and vegetables (with skin), quinoa, whole wheat bread/rice/pasta, oatmeal and barley. When increasing fiber in your diet, remember to do so gradually and drink plenty of water as this will help your body to process fiber without discomfort.

5. Adequate fluids. Drinking plenty of water post-operatively is great for the healing process and also helps to prevent weight gain by increasing satiety. Adequate consumption of water is also necessary to help digest protein and fiber, which are both important components of a healthy post-operative diet.

5 Ways to Avoid Weight Gain After Bariatric Surgery

In 2013, 179,000 bariatric surgeries were performed in the United States alone. As the obesity epidemic continues to grow, more and more individuals are considering the surgery as a treatment option. And while most patients do see significant weight loss immediately after surgery, continuing to lose weight — and keep it off — can be a challenge.

According to the American Society for Metabolic and Bariatric Surgery upwards of 50 percent of patients regain 5 percent of their body weight within 2 years of undergoing the procedure, while a smaller percentage of patients may gain back even more. So what can be done to increase the success rate of weight-loss surgery? Experts on the topic and individuals who have achieved long-term success with the treatment agree on this: Surgery is only the first step. The secret to permanent weight loss is to make lifestyle changes that stick. Here are five vital steps to prevent gaining weight back after undergoing bariatric surgery.

1. Get post-op support for long-term success. “Bariatric surgery is an emotional roller coaster — developing a support network is key,” says Michelle Lewis, LCSW, of Salt Lake Weight Counseling. Having an opportunity to freely discuss concerns, expectations, and challenges with others who have been through the same experience can be invaluable. “Support groups provide the answers to many questions and can guide you in ways that surgeons do not address,” states Esther Wolkowitz, who lost 133 pounds after the procedure and has kept it off for over ten years. “The support groups provided me with information on managing plateaus and food alternatives for the different stages of recovery. These groups also offer key moral support and encouragement pre- and post-surgery.”

Alceen Ford-Meggett, who has maintained her 132-pound weight loss for eight years, encourages people to not go through the life-changing process alone. “In the beginning I felt like a failure because I couldn’t lose the weight on my own. The support groups helped me with this. As with any support group you learn that you are not alone,” she says. Attending meetings helped Ford-Meggett identify her tendency towards emotional eating and change her habits. The groups also allowed her family to get involved and ask questions.

2. Assemble a health team. An important addition to every support system is a team of experts to guide you through the process, including a therapist specializing in emotional eating and a nutritionist, says Lewis. “Several studies have seen greater weight loss in patients who routinely follow up with a registered dietitian,” adds Kristen Smith, RD. “Bariatric surgery is only one tool in the toolbox for long-term success. Commitment to a permanent lifestyle change is a must and working alongside a team of experts can help a patient to commit to and maintain these changes.” Registered dietitians provide support and answer vital questions, while holding you accountable in preventing old eating habits from creeping back, she adds.

3. Rethink your relationship with food. For many patients who undergo bariatric surgery, the relationship with food is a complicated one. Rewiring yourself to think of food as fuel, instead of as an emotional comfort, is an essential part of the process. “Weight regain can occur if the relationship with food remains unchanged. If you struggled with emotional eating before surgery, the emotions are still there,” says Lewis. Paul Mason, formerly the world’s heaviest man, who lost 600 pounds through bariatric surgery and has kept it off since 2010, attributes his ongoing success to improving his emotional connection with food. “Work on creating a healthy relationship with food so that the emotional baggage that led to your weight gain initially is tempered or even squelched,” says Mason. With the help of your healthcare team, identify the emotional connections you have with food and work to change those patterns before and after surgery for the best chance at success.

4. Create new eating habits that will last a lifetime. As weight loss begins to slow, it can be easy to return to old habits and focus less on dietary guidelines. “Make sure to prioritize nutrient-dense foods,” says Lea Andes, RD, owner of BariAthletes. “Lean protein is important immediately after surgery, and continues to be, but don’t forget about fruits and vegetables, too.” In the years following surgery, as the stomach slowly expands and appetite begins to increase, incorporating low-calorie, high-volume foods like vegetables into your diet can be key to preventing weight regain.

5. Make fitness a priority, starting with the recovery process. “The body is made to move and the more it does, the better it works,” says Andes. Aim to be physically active most days of the week, and incorporate both cardiovascular and resistance exercises to preserve and build muscle mass, an essential component for a healthy metabolism, she says. After surgery, “walking is the foundation of exercise,” Andes advises. “Aim for small and attainable goals that you can build from.” She suggests increasing walking distance or time by 10 percent every week, or every 2 weeks if that feels too strenuous. “Once you feel like you have reached a good distance or time, you can start working on speed,” Andes adds.

Remember that slip ups are inevitable, but they don’t have to become major setbacks. “If you feel yourself slipping towards old eating habits, don’t be afraid to seek help,” says Smith. By building a strong support system, improving your relationship with food, and creating new, healthy habits, bariatric surgery can be a valuable tool in promoting long-term weight-loss success

6 Smart Ways to Lose Weight When You Have Knee Osteoarthritis

“It can help people to have a structured program in the beginning, so they can feel more confident that they won’t overdo it,” Lieberman says.

Without a physical therapist, for example, you might not realize that exercising your legs with weights, like with the machines you find in a gym, are not good for knee osteoarthritis. “It’s fine to do straight leg raises in a chair, which strengthen the quads above the knees. But it can injure the joint to push the leg against resistance,” she says.

Related: 10 Essential Facts About Metabolism and Weight Loss

2. Start working out in the water to help lose weight with knee osteoarthritis.

Whether you work with a therapist or on your own, the best way to begin an exercise program that you’ll stick with is to move without pain. For people with knee osteoarthritis, “that means swimming, swimming, swimming,” Lieberman says.

Moving in water — which includes pool aerobics or swimming laps — allows the joint to flex with no gravity or weight against it.

After you’ve built confidence and a bit of muscular heft, you can go on to other workouts, such as fast walking outside or on a treadmill, or using an elliptical at a moderate speed.

“Listen to your body after you do any workout,” Lieberman says. If you have pain that lasts more than a couple of hours after, stop and speak to your physician or physical therapist.

Related: Tennis Great Chris Evert’s 5 Tips for Embracing Exercise at Any Age

3. Pack each breakfast with protein to help lose weight with knee osteoarthritis.

Americans are good at eating enough protein and fiber for lunch and dinner: a salad with grilled chicken, a turkey sandwich with a side of slaw, meat loaf with veggies.

But breakfast is where many fall short, says Lauren Harris-Pincus, RDN, a registered dietitian nutritionist in Green Brook, New Jersey. Bagels, croissants — even healthier oatmeal — have nowhere near the 20 to 35 grams of protein per meal that are recommended and that keep us feeling full, she says.

Harris-Pincus, author of The Protein-Packed Breakfast Club, says pairing protein with fiber makes for the best meals, especially when you are trying to lose weight.

Her go-to: overnight oats, which she makes by filling a jar with oats, plain Greek yogurt (or nut or cow’s milk), a tablespoon of flavored protein powder, chia seeds, and fruit, then letting it soak overnight in the fridge. By switching up the fruits and the flavor of the powder (one day it’s pear-coconut, another banana-vanilla), she gets variety in her daily oatmeal.

Eggs offer another good protein-fiber breakfast choice. Make a vegetable omelet, or pair scrambled eggs with high-fiber berries like raspberries or blackberries.

4. Confront the emotions behind overeating to help lose weight with knee osteoarthritis.

Dietitians used to focus on giving clients information, such as advising them on which eating plans were best. Now many spend as much time helping clients understand the emotions they bring to food, which is crucial for successful weight loss.

“People eat because they’re happy, stressed, bored, angry, or in pain, not always because they’re hungry,” Harris-Pincus says. “We work to understand what motivates them to eat, which is very individualized.”

Of course, an appropriate eating plan is also important. “Any diet you can’t do long-term is not worth doing,” she says.

Some of the best diets for weight loss are the Mediterranean diet and the Dietary Approaches to Stop Hypertension (DASH), which are full of healthy foods like vegetables and fruits, lean proteins, whole grains, and healthy fats like nuts, seeds, and olive oil.

Harris-Pincus cautions, however, that if you are trying to lose weight, you must curb the portions of high-fat foods on these plans, like oils and avocados. “They are healthy foods, but they contain a lot of calories,” she says.

Find an RDN near you by putting your ZIP code into the “Find a Registered Dietitian Nutritionist” feature on the website of the Academy of Nutrition and Dietetics.

Related: Why Exercise Boosts Mood and Energy

5. Keep your eye on the prize to help lose weight with knee osteoarthritis.

Losing weight is a marathon. And like any marathon, you need to stay motivated when you can’t yet see the finish line. As with any project that takes a while, there will be highs and lows.

A good way to get through the troughs is to remind yourself of what you’re hoping to accomplish, including less knee pain, Lieberman says.

Related: How to Pick the Best Fitness Tracker for You

Lieberman likens weight loss to redecorating your home. “When you redecorate, you’re going to have covered furniture that you can’t sit on, the mess of painting your walls, and other discomfort and aggravations,” she says. But you go through it because eventually you’ll have a beautiful home. And if you stick with your diet and exercise plans, you’ll have your desired body weight.

Related: 7 Exercises to Help Relieve Joint Pain

6. Find a buddy to help lose weight with knee osteoarthritis.

Even when people with KOA know that healthy lifestyle habits will help them, it can be hard to stay on track. Research published in The Journal of Rheumatology found that joining forces with people who share similar challenges is a good way to motivate yourself to change bad habits.

Find a friend with knee osteoarthritis to exercise with, or if you don’t know anyone, ask around at events sponsored by your local Arthritis Foundation chapter to see if someone wants to pair up with you, Lieberman suggests.

“If you make exercise social and fun, you’ll want to do it more often,” she says.

How to Work Out With a Knee Injury

If you run, play sports, lift weights or age — so, that’s everyone — chances are high you’ll sustain a knee injury. It’s one of the most common ailments for the young and the old. In fact, about 2.5 million adolescent athletes visit the ER each year for knee injuries, according to the Society for Academic Emergency Medicine. Age-related injuries take their toll as well, with 14 million Americans suffering from symptomatic knee osteoarthritis.

The good news is it’s possible to keep exercising with a faulty knee. The first thing to know: Listen to your doctor. If she recommends you stay off your feet for awhile, then don’t push it, or you may cause further damage. Of course, not all injuries are the same. Rehabbing from a fracture or dislocation is different than rehabbing from a ligament tear.

Once you’ve been cleared to exercise, there are several moves and modifications to keep you mobile as you work your way back to 100%. Here are five:

1

STRETCH AND FOAM ROLL

“I’ve torn a meniscus and suffered other knee injuries, and I always start small when I return to exercise,” says Matthew Martin, certified personal trainer. “Stretching and foam rolling are both great ways to loosen up those unused muscles, especially if you’ve been in a cast or on crutches. Pay special attention to the quad, hamstring and IT band,” and you’ll prime your knee for movement and weight-bearing activities.

2

HOP ON THE BIKE

Cycling is a great, low-impact form of cardio that can strengthen muscles and lubricate joints, and it’s a common activity in all manner of rehab programs. The Arthritis Foundation recommends cycling for osteoarthritis sufferers and mentions recumbent bikes can be a good option if you require more support. One thing to avoid in the short term, however, is hills, as climbing puts extra stress on your knees.

3

STICK TO UPPER-BODY EXERCISES

“Knee injuries obviously limit what you can do at the gym, but there are still tons of exercises available to you,” says Martin. “Usually I will focus on the upper body, especially seated and supine work. You can work your chest, arms, back and more with dumbbells and machines, all without putting pressure on the knees.” Martin specifically mentions the dumbbell press, shoulder press, lat pulldowns and biceps curls as possibilities. “Ideally you want everything in balance, but you don’t have to neglect your whole body just because your knee is injured,” he adds.

If you’re ready to begin some leg exercises, he suggests starting slow and light with a mentality of “safety first.” Seated straight-leg raises, calf raises, bodyweight lunges and squats are all great, if you’re able to do them. To regain some stability in the knee, he likes standing on the round side of a BOSU ball to work on balance.

4

SLOWLY BUILD UP MILEAGE

If you’re a runner, too many days off can seem like torture. But you can’t expect to pick right back up where you left off. If you’ve been cleared to run, there’s a program to help you get started. According to running coach Jack Daniels, author of “Daniels’ Running Formula,” you can do some easy math to determine where to start.

He says if you’ve missed up to four weeks, you should spend your first two weeks back training at 50% your normal volume, and the next two training at 75% normal volume. If you missed more than eight weeks, you’ll need to take it even slower. In that case, he says to start at 1/3 your normal volume before moving to 1/2 and then 3/4. Doing so can help you get your fitness back and keep you from re-injuring your knee.

5

TRY SWIMMING

According to the University of Washington Orthopaedics and Sports Medicine, “Exercising in water is a gentle way to exercise joints and muscles. The buoyancy of the water supports and lessens stress on the joints and encourages freer movement.” Depending on the severity of your knee injury, you may not be able to kick, which makes swimming difficult. But if you can swim without risking further injury, it’s a great way to get some cardio while strengthening your muscles in a low-impact setting.

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