Exercise, Part 10: What If I’m Markedly Obese?

The more overweight you are, the harder it will be to exercise.  At some point even light exercise becomes impossible.  Average-height women tipping the scales at about 280 pounds (127 kg) and men at 360 pounds (164 kg) aren’t going to be able to jog around the block, much less run a marathon.  These weights are 100 percent over ideal or healthy levels.  An actual “exercise program” probably won’t be possible until some weight is lost simply through very-low-carb eating, calorie restriction, or bariatric surgery.  The initial exercise goal for you may just be to get moving through activities of daily living and perhaps brief walks and calisthenics while sitting in a chair.

"I'll get started after I finish this cigarette."

Markedly obese people who aren’t up to the aforementioned extreme weights can usually tolerate a low-intensity physical activity program.  At 50 percent over ideal weight, an average-height woman of 210 pounds (95 kg) is carrying 70 excess pounds (32 kg) of fat.  Her male counter-part lugs around 90 pounds (41 kg) of unnecessary fat.  This weight burden causes dramatic breathlessness and fatigue upon exertion, and makes the joints and muscles more susceptible to aching and injury.  If you’re skinny, just imagine trying to walk or run a mile carrying a standard five-gallon (19 liter) water cooler bottle, which weighs only 43 pounds (19.5 kg) when full.  The burden of excess fat makes it quite difficult to exercise.    

If you’re markedly obese, several tricks will enhance your exercise success.  I want you to avoid injury, frustration, and burn out.  Start with light activity for only 10 or 15 minutes, gradually increase session length (e.g., by two to four minutes every two to four weeks) and increase exercise intensity only after several months.  Your joints and muscles may appreciate easy, low-impact exercises such as stationary cycling, walking, swimming, and pool calisthenics/water aerobics.  You may also benefit from the advice of a personal fitness trainer arranged through a health club, gym, or YMCA/YWCA.  Check out several health clubs before you join.  Some of them are primarily meat markets for beautiful slender yuppies.  You may feel more comfortable in a gym that welcomes and caters to overweight people. Hospitals are increasingly developing fitness centers with obese orthopedic, heart, and diabetic patients in mind.

Steve Parker, M.D.

3 Comments

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3 responses to “Exercise, Part 10: What If I’m Markedly Obese?

  1. fredt

    How do you turn off an overweight person from reading your blog? be negative about there life style.

  2. I think this post is tactfully written, and has an overall positive message. The recommendations for increasing exercise were right in line with the American College of Sports Medicine. It’s true that people need to go gym shopping and find one that fits their personality and goals.

  3. Pingback: Fitness for the stupidly obese? | Mark's Daily Apple Health and Fitness Forum page