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Tuesday, February 19, 2008

Exercise, a Love Story

I was thinking of my exercise history today. To qualify for WLS, I had to submit a history of my obesity and attempts to lose weight and maintain weight loss. What I didn't have to document was my exercise history. It wouldn't be a bad idea to do this when preparing for WLS, because most people can't maintain weight loss without it. (Not all, though. And some people can't exercise after WLS, for various reasons.) Examining your relationship with exercise is a useful thing to do before undergoing something as life altering as WLS.

As a child, I never thought of myself as athletic. No one did, really; I was never an athlete, and no one ever pretended I was. I wasn't obese as a child--most of my childhood I was a normal weight, although I know I was always above 50th percentile, and below 50th for height. (This is a whole different discussion, though. I still deal with the fact that my ideal weight is going to end up being higher than the charts say it should be, because I have a very heavy frame. This is how it is on my dad's side of the family, and I'll never have a BMI less than 25, and I'm okay with that.) But I didn't like to run, I was very slow, and I preferred art and reading. I liked some sports, but wasn't good at them--I enjoyed volleyball and basketball, despite being a terrible shooter. In high school I swam a lot and toyed with the idea of joining the swim team, before I realized that my other extracurriculars--mainly music--wouldn't allow it. Late in high school, I was encouraged to join the gym with my mom, and I did--we went to "Living Well Lady" (remember them?), the all-women's fitness franchise from the 80s. I went, I did the same things over and over, without a lot of heart or enthusiasm. I hated it.

But, I was bulemic then, and did whatever I had to to keep weight off, and to "restrict" and "purge" as much as possible. I eventually outgrew bulemia, at about age 16 or 17. I just decided it was "dumb" and I was sick and tired of being sick and tired (that old cliche is pretty true) and I was going to eat. This decision was complicated by the fact that my mother has been anorexic and bulemic for her entire adult life--but I never turned back. I still had food issues, but I left that behavior behind. I had been pretty slim as a bulemic, through a lot of effort, but the weight came on fairly quickly after this period.

I continued to work out in the gym until I went to college. Then I stopped exercising altogether and continued to gain weight. I joined a gym sometime during nursing school, around age 21 or so, but went infrequently. I realized that I didn't like working out in gyms (I think now that I just didn't like the gyms I had been going to, but anyway) and decided to Never Do That Again.

Fast forward a bit. I graduated nursing school at my highest weight ever (even recently, I didn't get quite that high ever again, but almost). I started working, got married, lost a little weight and settled at a sort of set point for me for a few years. I got divorced, lost some more weight by going on phentermine, walking regularly, and being extremely stressed out. By the time 4 years had passed, I had gained about 30 lbs and went on Weight Watchers. On WW, I walked again as my exercise method, still thinking that gyms were not for me. I lost 35 lbs over about 13 months and stayed at my low weight, which was still 30 lbs from goal, for about a day before going back up. At that lowest weight I started running intervals, but not with much dedication--I was running in downtown Portland, which isn't very conducive to running effectively, and I didn't like it. I was too intimidated to run with my new boyfriend (now my husband) so we went on nightly walks together. But, the weight came back on over the next 2 years, and then some.

I started considering WLS in early 2006, but before getting too far with that thought, I decided to give one more gym another try, and I joined the YMCA in Portland in January 2006. I actually really enjoyed it. I started with the elliptical at a fairly slow rate, for 30 minutes 3 times a week. I didn't really advance it for long time. Then I joined the 12 week program, which is for new exercisers. It's a circuit, of sorts, of strength training, set aside in a special room. I enjoyed that, completed it and continued to do the program. By now I was up to about 40 minutes of cardio 3 or 4 days a week, at a moderate intensity. But, I found that I enjoyed it, surprisingly. I swam intermittently, although I couldn't do more than about 8 laps before getting worn out. My resting heart rate has always been high, and I maxxed out fairly easily then.

Then, the Y raised the dues, and my employer had just opened a new gym, called march wellness (no caps!). It was fancy and pricey, but with my employee discount it was cheaper than the Y. It was in our new Center for Health and Healing, which is a LEED building, very earth friendly, efficient, and peaceful. The gym is a marvel. I felt at peace there and loved being there all the time. So, I started going there in January 2007. But, since I left the Y and its routine of weight machines that I knew, I stopped with strength training. (What, you say? It's true. I never got around to getting a trainer at mw to get me a new routine, and I was too intimidated by the machines to start my own. I can't explain it, but strength training confounds me. I have to have someone show me a routine, then I can take it from there.) By the time I had my lap band surgery in March 2007, I was doing about 45 min of cardio, which included a 10 minute warmup of walking on the treadmill and a combo of elliptical and upright bike for the other 35 minutes, about 4-5 days a week. But now, my goal was 60 minutes of cardio 5 days a week. My primary doc had told me that the latest recommendations for exercise were 60 minutes a day of moderate exercise. I couldn't see any reason not to shoot for that (and still can't). So I worked my way up to that over the next 6 months. Still no weights.

Let me just add that during that year and 3 months between starting exercising again and having WLS, I continued to gain weight. I got in better shape and had more energy, but I gained about 20 more pounds during that time. Exercise alone might work for some people, but not most of us who end up morbidly obese. A lot of us are "fit fat", which is what I was. In fact, if I hadn't had obstructive sleep apnea, I never would have been approved for surgery by my insurance.

When I moved to Spokane to start graduate school 3 months ago, I had to find a new gym. Actually, I didn't find a new gym until December, since I was still mostly in Portland and was still going to march wellness. Leaving that gym was one of the hardest things about moving away from Portland. It was such a haven for me, I just loved being there. I took yoga there, I took pilates, I worked out, I relaxed. I just loved it. Spokane is not a very gym friendly town. I finally settled on the YMCA in Spokane Valley--there is a Y closer to me, but the facility is very old and run down. I've blogged more about the Y (aka McDonaldland), it's a pretty nice facility but overrun with small children. I had some fit-testing and body composition testing (which I doubt was as accurate as what they did when I started the WLS process) and discovered that while I had lost 45 lbs, I had only dropped my body fat percentage very slightly. Oops. Guess where I lost the weight? Guess why I was "plateaued"? Yeah, you need muscle, and quitting strength training right when you have WLS probably isn't a great idea. So I got a new strength routine and kicked it up.

Now, I work out 5-6 days a week. I do my whole strength routine in the same day, usually, if I have time. I take one day off afterward, but do cardio that day. It ends up being 3 days a week that I lift. I increased the intensity of my cardio workouts in the fall, and some more when I started going to the Y--faster elliptical at a higher resistance level, much faster walking on the treadmill. I started using the treadmill more, because you can't get "lazy" and go slower without thinking about it like you can on the elliptical, and I increased the speed of my walking.

Two weeks ago (for the sake of tracking my progress, I am going to say Feb 7) I started running intervals again. I walked about 20 minutes, at 3.0 to 4.0 mph at a 6% incline, then ran for 4 minutes, walked 5 minutes, and ran another 3, then walked the rest, ending up with about 45 minutes total. A total of 7 minutes running. I've now increased to 10 minutes running (3 min, 2 min, 3 and 2) and I'm just looking for slow, steady improvement. I don't run because I really like it, but because I want more bang for my workout time or "buck". I COULD just walk for 2 hours, but who has that kind of time? I will never consider myself a "runner". I won't do a marathon, or a half marathon, or probably even a 5k. But I will try to increase my running (on a treadmill, where my joints don't have to absorb all the force of my still-technically-obese weight) and see if I start enjoying it more as I get more fit. My resting heart rate has come down, from 110 (!!) a couple years ago to 84, and my heart rate recovers more quickly than it used to when I work out hard. I get up to about 175 when I run, so I can't sustain that for longer than a few minutes at a time, but hopefully it will continue to improve. Previously I've tried to keep my heartrate between 145-155 (higher than most people my age would, because my resting rate is higher than most) and hopefully I can eventually run for a longer period and not go higher than 160 or so. At some point I might get a heart rate monitor to keep better tabs on this.

But the biggest surprise to me of all of this is that I love to exercise. I don't love to run, and I don't always feel like working out, but what gets me there anyway is knowing that as soon as I dress down, I am ready to go, and I always feel great, during and afterward. My overall energy level is so much greater than it was a year ago. Sometimes I am afraid that something will get me to stop going and working out, and I think that actually motivates me to keep going. I don't ever want to go back to my life before exercising regularly. I just didn't feel like doing anything.

There is a quote that I think of often with regards to exercise, and it is from, of all people, Kate Hudson. I read an interview with her, and she talked about exercising whether she felt like it or not, and always feeling like it eventually, because "It feels good to move." She is so right. You have to move your body, and keep challenging it.

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