We’ve all heard it: to lose weight, we need to eat less and move more. While endobariatric patients are almost always going to start off eating less, many find it a struggle to move more. Yet, we know that regular exercise is very helpful for patients trying to lose or maintain weight.
Exercise is helpful for a number of reasons, but when it comes to weight loss, in its most basic function—it helps you burn more calories. This helps you get closer to the calorie deficit needed to lose weight. “You can’t compete with what you eat,” said Emily Weaver, nurse practitioner at True You Weight Loss. “However, if you can take in fewer calories than you are burning, weight loss is the reward—and exercise is the best way to accomplish this.”
Additionally, exercise is extremely beneficial for mood, mental health, and physical health. Because excess weight is closely tied to depression and anxiety, exercise and weight loss can help fight against these emotional challenges, lighten your mood, and put you into a more positive and productive frame of mind. Boosting your mood can help improve every facet of your life and lead to continued weight loss progress. The cardiovascular benefits of daily exercise are impressive as well, including improved blood pressure and cholesterol levels, as well as a reduced risk for diabetes, stroke, and heart attack.
Many patients tell us that engaging in physical activity after an endobariatric procedure can be intimidating. Oftentimes, patients are unsure about moving too much right after a procedure, and with limited caloric intake, many worry they won’t have the strength or stamina.
“I typically tell my patients that there are no true physical limitations to exercise after an endobariatric procedure,” explains Weaver. “You are not going to damage anything by moving around or lifting. However, avoid vigorous physical activity, such as heavy lifting or extra exertion for the first few days. In the first few weeks, because your caloric intake is lower, you may only have enough energy to sustain light activities.”
Light activities include walking, swimming, and using a stationary bike. After two weeks post-procedure, you should gradually increase your level of exertion to tolerance.
When it comes to exercise, it’s important to know how much will deliver the results you want. Many different health and government agencies have issued recommendations on what level of exercise is necessary for healthy adults. For example:
At True You Weight Loss, we encourage patients to engage in 30 to 45 minutes of cardiovascular exercise per day, plus two days per week of strength training. Often patients will start by incorporating moderate cardiovascular activities into their day, such as walking, running around after their kids in their yard, or doing yard work.
When it comes to getting started, Weaver cautions patients not to go overboard, and to develop a routine that’s sustainable for the long-term. “If you don’t see yourself maintaining your post-procedural workout regimen for the long haul, then it is not worth starting,” says Weaver. “Instead, establish a regimen you feel you can stick with for years. Start small and work your way up gradually. This way, you can prevent injury or a feeling of defeat—and you’ll wind up with a routine you can keep up with.”
Generally, 20 to 30 minutes is sufficient for a good strength workout, but this can be broken up into smaller intervals if you can’t set aside 20 dedicated minutes. For instance, if you are at work, keep resistance bands at your desk and take five-minute breaks throughout the day to use them. Or, take a five-minute walk several times over the course of the day.
However, be careful not to overdo it with exercise. When you exercise too much, stress hormones will trigger hunger hormones and inflammation that can inhibit weight loss or actually lead to weight gain.
“Sometimes less is more,” Weaver explains. “Move every day? Yes. Kill yourself while doing it? No. Weight loss is all about sustaining—there is no finish line.”
While recommendations and guidelines are helpful, some patients simply just don’t enjoy exercise or feel too intimidated to join a fitness gym. To these patients, Weaver recommends thinking outside of the box and finding other creative ways to enjoy physical activity.
“I don’t care how you move your body as long as you are doing it,” she explains. “If you like dancing, dance in your living room. If you enjoy swimming, find a pool and go swim. Find something you enjoy, and just get out there and keep trying new things until something clicks.”
Weaver also recommends experimenting with different online platforms that allow you to try new and different exercise methods from home, or try recruiting an exercise partner or family member to try new things with you. Even choosing to regularly do something fun and active with your children can fill your exercise bucket.
Other ways to increase your overall daily activity can be found in non-exercise activity thermogenesis or NEAT. This is the energy expended by performing normal daily activities on a regular basis, such as walking from the parking lot to the store or climbing up and down the stairs in your apartment building. If you are a patient who hates exercise, try increasing your daily activity and therefore your NEAT (especially on days without a set workout plan) by taking a few extra laps around the store, parking farther away from your office building, or taking the stairs instead of the elevator.
Additionally, try to remove the anxiety over gym membership by scheduling a free orientation with a personal trainer who can give you a tour and show you the basic equipment. You may find that this type of experience will build confidence and create a sense of comfort.
“The hard part is getting started, but being part of a supportive counseling program and weight loss community can help you stay motivated and stay on track,” says Weaver. “I see it every day when I meet with patients for follow-up appointments. They are more vibrant and confident, they are sleeping better, and they have more energy. When you find the time to devote to your health, everything falls into place.”
Another key piece to exercising for weight loss is discipline. While most bariatric patients feel deeply motivated to lose weight going into their bariatric procedure, motivation is a fleeting emotion and is hard to maintain.
“You are not going to feel hyped and motivated to exercise every day. In fact, after your procedure and the first few weeks of recovery, you may not feel motivated anymore at all,” warns Weaver. “The daily grind of exercise and weight loss is truly all about discipline—remembering that when you move, you are doing your body a service, and you are going to feel better afterward. Using self-discipline is crucial. You may not want to exercise, but you know you need to and that you are worth it, so you press forward.”
For example, a patient who really wants to reach his or her goal weight quickly might go to the gym twice a day for two hours for six months in a row. He or she then reaches that goal weight quickly and stops exercising. Unfortunately, this will lead to a vicious cycle of yo-yo weight loss and weight gain. However, if a patient can start with small goals, like going to the gym for one hour, five days a week, he or she is more likely to maintain this routine longer and see long-lasting results.
“If you can’t maintain your routine for one or two years, then don’t even start it,” advises Weaver. “Start smaller and build a sustainable exercise plan that you can maintain for the long-haul. I am much more supportive of doing something that you can realistically do forever.”
Meanwhile, every bariatric weight loss patient should remember that you don’t have to go it alone. Weaver recommends finding an accountability partner or workout partner, whether it be a spouse, close friend, or neighbor, and create an exercise routine together. This will add an extra layer of accountability to exercise, making it more likely that you will show up for workouts and making them more enjoyable. Scheduling activities can also be helpful, but don’t be too regimented. Having a plan is good, but have a back-up plan as well.
“If you miss a workout class because your meeting ran late or you got stuck in traffic, be flexible enough to pivot and do something else,” says Weaver. “Take a walk once you get home or do a workout video in your garage. Don’t allow yourself any excuses to skip exercise.”
Weaver also recommends tracking your daily steps to hold yourself accountable, with 10,000 steps being the daily goal, but she also says not to rely on calorie counters (on machines or wearable devices) because they can be wildly inaccurate and can lead to unhelpful misconceptions about your progress.
Finally, we all know that life can be incredibly busy, and often finding time for cardiovascular exercise drops to the bottom of the priority list. Therefore, it is important to look at your week ahead and plan for when you will be able to fit exercise into your schedule. For example, can you take a walk or run around the field while your child has soccer practice? Can you get up early for a spin class before your 9 a.m. meeting? Writing down your plan, or typing it into your phone or online calendar, can be incredibly valuable, and checking it off your list once complete can be incredibly satisfying as well.
“Plan around your lifestyle, and find the windows of opportunity for exercise. Make this practice a part of your daily and weekly routine,” adds Weaver. “And even after you meet your weight loss goal, keep up your exercise routine because staying active is critical to long-term success and sustained good health. If regular exercise becomes a part of your life and lifestyle, then you will reap multiple health and emotional benefits that reach far beyond your initial weight loss success.”