Sunday, December 20, 2009

Barriers to Exercise for the Overweight

I've been having an interesting conversation on Twitter with Bill Yates, MD (@wry999). He made an excellent blog post about exercise attitudes in the overweight at:

I posted a reply complimenting him on the post. I added that most obese women will not swim, even though it is one of the safest and most effective exercises for large people, because they don't want to be seen in a swimsuit.

He replied, saying that I had a good point. Did I have any suggestions for breaking through these attitudinal barriers?

I've found that classes where all the participants are large seems to help, especially if they’re in an area with little foot traffic. Exercise videos that people can do behind closed (and locked) doors also help. Our culture's shaming of the obese is not helping the problem. We often use shame as a motivator. These people often have a motivation to exercise, but their fear of public exposure and criticism is a stronger motivation to avoid it.

I didn't realize how little I care about the opinions of others until I began interacting with other people on . I was willing to do the swimming, the public walking, the struggling with weights in front of college-aged men. I even did a few sessions of hip-hop and Zumba classes with slender young things wearing official exercise clothes (I was wearing baggy shorts and old T-shirts). Most hardbodies aren't cruel, and the young men at the YMCA even cheered when I managed to get the overhead press over my head. My flat feet and weak back stopped my progress on several occasions, but never embarrassment.

I realized, as I mentioned this, that there is another barrier to exercise for large people that was not mentioned in the study Dr. Yates reviewed: most exercise videos and classes are geared to the already fit, not the beginner and/or the obese. It takes longer to learn the moves, we don’t move as quickly due to our size, and we are slamming a lot more weight on our joints than most people. Some people drop out, discouraged, while others (like me) wind up in physical therapy (I'm a three-time 'winner' in PT). I have videos on my shelf that I tried once and put away because I knew they could injure me (including one Tai Chi video that did injure me).

I've lost about 70 pounds. Most of that was done through eating less, but it was also done through walking, public swimming, strength training at home without weight machines, and Leslie Sansone/SparkPeople videos. The shaming needs to stop, and more exercise programs need to be tailored to the special risks of the obese.

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