Being in the health industry, I have witnessed firsthand the destruction, cost and enormous pressure obesity is putting onto our health system. It’s scary to think where this epidemic will lead us. I feel in some ways we are already preparing for the worst. Hospital room sizes are now becoming larger, lifting equipment with larger weight ratings is being purchased, and constant training in how to manage obese patients from a mobility and safety issue has to be continually updated. This continual increase in obese patient admissions into hospital is also placing our health professionals at a greater risk of injury. It’s a concerning picture when looking at the statistics and seeing the rise in obesity despite the knowledge of the risks it poses and the coverage it has received in the media. With this in mind, I decided to look into the statistics. I chose to look at the Australian Government website Australian Institute of Health and Welfare to obtain the below statistics:
Almost 2 in 3 adults (63%) are overweight or obese
10% more adults are overweight or obese than in 1995
15% more people living in outer regional and remote areas are overweight or obese than people living in major cities
Overweight and obesity is the second highest contributor of disease, after dietary risks
Over 1 in 2 Australian adults (56%) are not sufficiently active
(Australian Institute of Health and Welfare 2016)
I’m not sure what is more concerning, that 63% of adults are overweight or obese or the fact that 10% more adults are overweight or obese since 1995 (Australian Institute of Health and Welfare 2016). This rise in overweight and obese adults is even with the launch of the biggest loser in 2004 and the increase in publicity which the subject has received. We now have twenty-four-hour gyms and therefore no excuse not to exercise yet we are still failing to turn the trend. I think when looking at this epidemic, it seems too big to conquer therefore I feel it is important to break the problem down to improve our success rate. Specifically, we need to look at the barriers to combating it successfully, what stops people from continuing their transformation and what we need to do.
Barriers to success:
Increased sedentary lifestyle, with the development of technology the reliance of manual labour has reduced and resulted in the need for more sedentary jobs. With a larger portion of the population employed in sedentary jobs results in less incidental exercise being performed during the day. This reduction in incidental exercise does not mean we come home ready to go to the gym or for a walk rather it is quite the contrary we return home mentally drained and can’t wait to crash on the couch and increase our sitting time further. Additionally, the use of active forms of transportation has also declined over the years. It would be interesting to see the obesity rates of Copenhagen where the reliance on bikes and walking for transport is high.
“Time poor” is a word we now hear a lot more this coupled with the financial burden and subsequent pressure to have dual working parents is resulting in poor processed food choices. As we have all heard over the years our diet is a major factor to our success in losing weight. We have all heard the saying before that weight loss is 80% diet and 20% exercise.
This dot point relates to the above – reduced exercise participation which as we all know impacts on our health for a variety of reasons
Subconscious and emotional barriers – Going to the gym for the first time, going for a walk along the street or being seen exercising as a larger person can be daunting, confronting and overall embarrassing all rolled into one. This can be a large factor preventing you from starting or staying motivated to continue. Having the feeling that people are watching you and judging your performance, effort and appearance are horrible and hard to move past
The next list of issues we face comes once we build up the confidence and motivation to make a change. Making the decision to start is always daunting but something to be proud of. In some ways, I believe it is much like quitting smoking in that success cannot always be achieved in the first attempt. Being persistent is important! When you are successful it is extremely rewarding and something to be proud of and something that you should use to motivate others. It is easy for fitness gurus, researchers and the like to tell you what to do but sometimes this still feels out of reach. We all need some reassurance that it is possible as we can lose faith with our failures. Personal experiences are great as you can gain confidence that others have come before you and succeeded. With hope comes great power to make changes. My personal experience and battle with weight can no way compare to some of the difficulties others face. But it is an example of how ones passion for exercise can transform with time and some determination. I was overweight in early high school, don’t get me wrong it wasn’t significant and most people who could remember back to that time would have actually forgotten about it. I was embarrassed to go for a run on the streets and did not like others watching me exercise. I would even find ways to avoid going to football training as I was embarrassed, looking back on this it was concerning considering my love for football and sport in general. This was a large barrier as it caused a cycle of events until one day I said enough is enough. I found my personal motivation and forced myself to run. Initially, I ventured to the local oval and ran laps only when no one was there. I would even stop my session if someone else arrived at the oval. As time passed, my self-confidence grew to allow me to complete sessions when others were around. This confidence eventually developed to running on main roads. My drive to run continued to grow to a point which in some ways would be seen as unhealthy in that I was addicted to running. In fact, once I completed year 12 it got to a point that I found myself finishing tea feeling guilty and forcing myself to run even if it was nine, ten or even eleven pm. Eventually, I found my insecurities helped my fitness progression. I was so paranoid that everyone in their car was watching me that it pushed me to run faster and faster. I look back at this and see how dramatically my mental strength and passion for exercise has changed. Now I am currently outrageously time poor and finding it difficult to exercise this at one stage would not have bothered me yet now it is eating me up inside.
Once starting your transformation some of the barriers which you may face include:
Injury – with increased weight, a sudden increase in load and other biomechanical factors, unfortunately, injury is a real possibility and something that can stall your progression and worse cause you to give up
The speed of results – the Biggest Loser was amazing to give others the confidence, motivation and desire to make a change. The only issue is when you are unable to emulate those on the show and lose weight at a similar speed we can get disheartened which can cause us to give up. It is important to remember the actual time periods of the show and to take into account that you are trying to achieve this often by yourself and with the added difficulty of working or running a family Time always plays a role in the success of one’s health goals. As previously discussed this is on two levels firstly with the preparation of meals and secondly finding time to exercise regularly
Diet – this is a huge factor regarding success either you haven’t addressed your diet and therefore are not getting the results you desire and lose motivation. Or you have gone the other direction and radically changed your diet which is not sustainable. Overall I promote healthy eating for life, this needs to be a life change rather than a diet as you need to be able to maintain your dietary changes for life rather than a specific period of time for true long term success.
By no means does this list cover all limiting factors to the success of your goals so if any other limiting factors come to mind don’t hesitate to place them in the comments below as I am sure many others would be experiencing additional limitations. This way we can devise structures to assist you to combat your difficulties. Now that we are aware of some of the barriers to success lets look at strategies to combat them:
Pacing
Pacing is critical when starting a new exercise program or individual exercise. As a guide always start at a low intensity to see how your body will react. It is also import to keep in mind that it might not be a particular exercise that you have difficulty with rather the build-up of multiple exercises or your program as a whole. For example, you may be training legs and performing squats, lunges, knee extensions and step-ups one day and then focussing on your cardiovascular system another day choosing to run or ride. With this number of exercises recruiting your quads, you would need to keep a close eye on your quads length as they will potentially tighten up if not managed appropriately. An overactive quad can increase the joint reaction force at your patella femoral joint resulting in patella femoral joint pain; this overactivity could also manifest itself in the form of a patella tendonitis. The main point to note here is that you need to manage your recovery appropriately as this will keep you able to perform the tasks required to reach your goals.
Accountability
Going into a program alone it is not easy to maintain motivation as you are only accountable to yourself and if you have poor resilience, you may find your beaten before you begin. If others don’t join you on your journey at least get them involved to keep you honest in some way. It could be as easy as setting a challenge, timeframe or accomplishment that they can check in on your progress periodically. Knowing others are watching your progress or having someone to meet for your next session is a proven way to improve participation. Groups are another great way to keep motivation high. The comradeship and sense of responsibility to the other members of the group helps to keep you on track. If in doubt a mentor can be another option to help keep you on track to success
Program
It is important to have a program; it doesn’t matter how simple it is! Having something to follow and provide you guidance and taking away the decision-making process is the important thing. As I have discussed previously a simple program followed always is superior to a detailed complex program sporadically performed. Have a plan, be disciplined and consistent and the results will follow.
Eating Plan
There is so much information out there regarding your diet good and bad. If you are really serious making a change I do recommend you make an appointment with a dietitian to sit down and develop an eating plan. I also recommend you obtain general nutritional information around food from your appointment as it is interesting how little we understand about the food we put into our mouth. If this is not achievable I feel starting with cutting your poor food choices by half (we all have a good idea what these are) combined with an exercise program is a good start. As you improve and see positive results keep performing some research on healthy food choices and try make subtle changes to your current diet.
Encourage others to share their story as there is not one right path to success!
Talk to Body Fit Physiotherapy to support your health journey.
References
Australian Institute of Health and Welfare 2012, Overweight & obesity, risk factors, disease & death, viewed 15 September 2016, < http://www.aihw.gov.au>.
Created By:
Tim Delvins
Body Fit Physiotherapy North Adelaide