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Article on Post Bariatric Surgery Exercise
By Robin Del Pesco
July 2007 About Robin Del Pesco Certified Personal Trainer and owner of LA Private Trainers Inc, Robin Del Pesco operates Southern California's most prominent personal fitness training company with a wide range of clients in all ages. Everyone wants to live a fitness lifestyle. But what if your health prevents you from having this option? This is the plight of millions of obese people. I have over 25 years of experience and I've helped about 13000 lose weight and get healthy through exercise. After working closely with physicians who treat obesity and morbid obesity, I have had the opportunity to develop a post bariatric exercise program that offers patients safe gradual recovery with a progressive fitness solution. If you suffer from obesity, I understand how difficult it is to start and stick to an exercise program. Aside from the obvious reasons, I attribute the difficulty of weight loss in the morbid obese to the metabolic changes that take place once the body exceeds 30% plus body fat. Fat cells that are stressed respond on overload and send chemical messages throughout the body. This prevents the body from responding to exercise like most people. Obesity requires a lot of calories to maintain and so cravings are for dense calories like fats and sugars to satisfy food cravings. The body demands calories subconsciously first based on body weight. What this means is a 150lb person will require a minimum of 1500 calories to sustain body size. But a 300lb person will require 3000 calories. The more weight the more calories needed to sustain that weight. When body fat gets this excessive, a person loses the ability to decipher how many calories they need. Weight loss of a hundred or more pounds would require a caloric deficit day after day for a period of about 1-2 years, and most people find it difficult if not impossible to meet that challenge. Weight loss via exercise takes place through cardio respiratory (oxygen) training and an increase in VO2 Max. Flat foot syndrome, shin splints, ankle and knee pain from overstrained joints and ligaments are common complaints during exercise sessions and will limit the options for cardio respiratory adaptation. Exercise as a single solution to morbid obesity becomes a challenge because the client and trainer are faced with these physical limitations and the likelihood that the calorie restriction and exercise combination is a slow and often arduous process. The best combination to treat this kind of weight gain is a combination of exercise, diet modification and bariatric surgery. The Story of Bill. Bill was a client on my training program for several months before deciding to have bariatric surgery. He had struggled with his weight for years toggling between 310 and 375 only to realize moderate success in every weight loss attempt. When I began training him he lost about 20 lbs. Bill and I discussed bariatric surgery and I told him that in my opinion he was a good candidate. He had improved his cardiac output by 10%, had become much stronger and he felt that the surgery would accelerate his results and drastically change his weight. He had been on a training program that included cardiovascular exercise in combination with progressive strength training of each major muscle group, ending each session with a flexibility routine for his joints. His surgery was hard on him and he was on bed rest and limited activity for the first 8 weeks. On his first session back he had already lost 50lbs, which put him at 305. One of the major challenges with post bariatric surgery exercise is that you have forced restriction of calories. This means your body can get weak and fatigue quickly. I worked with Bills' doctor and put Bill on a diet of healthy complex carbohydrates before his exercise sessions and high quality protein after the sessions for recovery. Fat can be used as a source of energy during exercise, but the body will use up whatever glycogen (sugar) is in the bloodstream and stored in the muscle before it breaks down fat. This takes about 15 minutes. Bottom line is you will accelerate weight loss with a moderate cardiovascular exercise regimen. As Bill began shrinking before my very eyes, he also got stronger. I put him on a strength training program with low weight and high repetitions to limit fatigue. His muscles responded better at 275 lbs than they did at 375 because he could deliver oxygen more effectively to his muscles. I was able to continue to increase his cardiovascular endurance training as he lost more and more weight. Bill was excited that his options for exercise also expanded with his shrinking body fat. He could balance better and take bike rides with his kids, use the before dreaded Stairmaster, and some light jogging. Even though he could only eat a small amount of food, his body responded to a progressive increase in exercise intensity. I monitored him with a heart rate monitor in every session whereby he and I could see his heart rate during and after exercises. We began adding core training exercises and Bill was excited to see and feel abdominal muscles and shoulders that had been hidden with fat for over 20 years. The door opened for Bill to experience the benefits of a fitness lifestyle. |
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