Weight Loss Surgery Forums

Fitness Q & A 
 

Fitness expert, Jeremy Gentles, MA, CSCS shares his expertise and insights with OH Members in this Q & A session.

Question: I had lap Roux-en-y a month ago and am now using a treadmill, but I wonder when it will be safe to go back to Curves and to do weight bearing exercises?

Answer: While the recommendations differ from surgeon to surgeon, it is often suggested that individuals who have undergone weight loss surgery, wait at least six weeks prior to engaging in or starting a resistance/weight training program. One of the primary risks of participating in intense exercise after abdominal surgery is developing a hernia. It is important however to remember that light cardiovascular exercise is appropriate very soon after weight loss surgery whether it be done by using a treadmill, walking, stationary bike, or many other options.

Some of the variation in suggested wait times depends on what type of weight loss surgery you may have had to include whether the surgery was done laparoscopically or open. Standard suggested wait times for participation in weight training after weight loss surgery may also change as less invasive weight loss surgery options are available.
 

Question: I am post-op and approximately 230 pounds. At what body weight should I get down to before I start running and should I begin running on a treadmill rather than the street?

Answer: There is no standard in regards to what body weight you must achieve prior to initiating a running program. With this said, there are several points you should consider prior to running:
• Running is a fairly high impact activity that may further complicate any orthopedic issues you may have. This may further be exaggerated if you are still obese or overweight. Please seek medical clearance for general exercise participation and more specifically, any orthopedic problems that may limit your exercise participation.
• Using a treadmill will reduce the amount of impact associated with running and/or walking so you may want to consider starting with a treadmill rather than the street, sidewalk, or track. 
• One of the factors most frequently overlooked by recreational exercisers is proper shoes. You MUST get the proper shoes for the type of feet you have and the activity you will be participating in. Runnersworld.com has great information about fitting and finding the proper footwear. 
• Take your time! If you are new to running or have not done it for years, begin slowly and at a low intensity. Check out the Fitness Forum at www.obesityhelp.com/forums/fitness for detailed guidelines about how to design a cardiovascular training program.

Question: I often feel nauseated towards the end of and after my exercise sessions. Will taking protein prior to working out help this?

Answer: This is a common issue experienced by individuals who are under significant caloric restriction whether this caloric restriction is caused by a very low calorie diet or weight loss surgery. With this said, protein by itself will do little to stop this.
During periods of rapid weight loss and low caloric intake, there are a couple of issues to consider. First, exercising muscles need energy to perform and that energy comes from the calories you consume through food. Since weight loss surgery and very low calorie diets limit food intake, especially the amount and type carbohydrate (simple vs. complex) in many cases, it is safe to assume this may impact exercise performance in a negative manner. Secondly, during most forms of exercise your body prefers and/or utilizes a storage form of carbohydrate called glycogen. As glycogen is used and depleted, blood sugar/glucose is pulled from the blood to be used for energy production and to replenish muscle glycogen. Again, dietary restrictions limit how well you can do this. If caloric intake is low, particularly carbohydrate (not protein), it is difficult to get enough carbohydrate or sugar into the blood to replenish muscle glycogen and maintain proper blood sugar levels. Nausea may result due to a drop in blood sugar, a consequence of the combination of low carbohydrate intake and intense or long durative exercise. 
Since the total number of calories you can consume is reduced and many after weight loss surgery cannot consume beverages such as Gatorade during exercise, pre-exercise nutrition becomes extremely important. So often we hear about the significance of protein after weight loss surgery and/or in combination with exercise, the importance of carbohydrate is frequently overlooked. Pre-exercise carbohydrate ingestion is key for stabilizing blood sugar and providing a readily usable form of energy during exercise. Thirty to sixty minutes prior to exercise try consuming a carbohydrate rich whole food such as an apple, a banana, a piece of whole grain toast, or some oatmeal (no sugar added).
 

Question: Should I perform my cardiovascular exercise prior to weight training or vice versa?

Answer: Much of this has to do with you exercise goals and preferences. If you really enjoy weight lifting, do this first so you are not fatigued from performing cardiovascular exercise. If you enjoy cardiovascular exercise, do it first so you are not fatigued from weight training. In regards to health, there is no evidence to suggest doing one before the other is better but participating in both does seem to be best. The best type or order of exercise/physical activity is the one you enjoy and can create a habit of. Bottom line, do what you like to do!
 

Question: I am only able to perform cardiovascular exercise for 10-15 minutes at a time. I know I need more, so what can I do?

Answer: The American College of Sports Medicine (ACSM) recommends 20-60 minutes of continuous or intermittent activity throughout the day on all or most days of the week. While exceeding 60 minutes of physical activity a day is not discouraged, 20 minutes of total cardiovascular exercise per day represents the lowest amount of time that will continue to produce improvements in aerobic capacity over the long-term.
Notice the phrase “continuous or intermittent? in the above paragraph. Research has shown that combined intermittent physical activity throughout the day produces the same or similar results as continuous activity. In other words, walking three separate times a day for 10 minutes will produce the same results as walking one time a day for 30 minutes. So, shorter periods of exercise throughout the day are the answer.

Question: What’s the deal with appetite and exercise? I have heard that exercise increases your appetite and results in an increase in the number of calories a person consumes each day. Is there any truth to this?

Answer: The majority of research does not support the idea that physical activity increases an individual’s appetite or perception of hunger, nor is it associated with an increase in caloric intake. While it seems to make sense that a person will eat more often when exercising regularly in order to meet energy demands, the scientific evidence does not support this.
In fact, there is evidence to suggest that exercise may actually increase dietary compliance. In other words, if you are following a nutrition plan, exercise may help you stick to that plan. Think of exercise as a “gateway? activity. As you include healthy activities like exercise in your daily life, this opens the door to additional healthy behaviors such as consuming a proper, healthy diet.
While we learn more and more about the relationships between exercise and appetite, there is certainly room for further research.
 

Question: Will working with weights make a woman bulk up?

Answer: Gaining excessive muscle tissue or “bulking up,? as a result of weight training is generally not a concern for most women, despite the frequent misconception that women will “bulk up? if they exercise with weights. For many years, weight or resistance training has been most popular with men, largely in part due to the fact men are often able to add a significant amount of muscle tissue. While women can gain muscle tissue through weight training, it is unwise to think a woman will gain muscle tissue or “bulk? the same way a man will. There are multiple reasons why this is not generally an issue for women. 
First, testosterone is a very powerful muscle building hormone and women naturally have lower levels of testosterone than men, making it more difficult to bulk up excessively.
Second, anyone who is currently on a low or very low calorie diet and individuals who have had gastric bypass or another weight loss surgery procedure will have a harder time building excess muscle, because muscle building is an anabolic process which often requires an excess caloric consumption to occur, especially over a long period of time. In other words you need to consume more calories than you burn throughout the day. That is not to say that you can’t gain any muscle without consuming excessive calories, but to really acquire excessive amounts of muscle tissue, you would need lots of calories for a long period of time in conjunction with a properly designed exercise program. For individuals on very low calorie diets or those who have had bariatric surgery, it is very difficult and often impossible to consume enough calories to gain too much muscle tissue. In fact, loss of muscle tissue as a result of too few calories is far more often the concern.
 

Question: Can a person develop an effective fitness program without having to consult with and pay a personal trainer?

Answer: It is possible to design your own safe and effective fitness program without the assistance of a properly educated and certified personal trainer, butm you must identify and utilize the proper resources. Three “gold standard? organizations who offer exercise recommendations and I suggest you follow are the American College of Sports Medicine (ACSM), National Strength and Conditioning Association (NSCA) and American Council on Exercise (ACE). Please, do not rely on so-called fitness magazines you often find on the newsstand. If you do pick one up, look for references from one of the three aforementioned organizations. In fact, the ACSM publishes a great book:ACSM Fitness Book.

Be sure to visit our fitness forums at www.ObesityHelp.com/forums/fitness for more great information that will help you train for your journey.
 

Ask The Expert! Do you have a fitness question?
Post your questions below and we will invite fitness experts to respond.