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Creating Welcoming, Inclusive Health & Fitness Environments for People with Obesity

/28 December 2021/ All MFN blog/

Each year for the past several decades, the health & fitness industry has served approximately 20% of the population, primarily helping the fit get fitter. Eighty percent of the population joined a health & fitness center but did not stay, or never joined because they decided it was not the right fit for them. A movement is gaining momentum to change that, and to make the health & fitness industry more inclusive and welcoming of people of all different ages, shapes, sizes and abilities. 

Worldwide, rates of obesity have tripled in the past 45 years. More than 42% of Americans have obesity, with the prevalence in the United States rising over 12% in the last 18 years. This presents an untapped opportunity for fitness professionals with specialized knowledge and expertise in working with clients with obesity. 

Dr. Rachele Pojednic and I have developed a MedFit Classroom Specialist Course. Presented in 10 modules and requiring 10 hours to complete, the Obesity Fitness Specialist course defines obesity and weight bias and identifies the biological, developmental, environmental and lifestyle factors that contribute to obesity. It explores solutions to obesity using the Socioecological model and empowers fitness professionals to be a part of individual-level, as well as institutional- and community-level, solutions. 

Learners will be able to position themselves as obesity fitness specialists separate and distinct from weight management and weight loss specialists. They will be able to create safe and effective programming for clients with obesity and inclusive environments that can lead to sustained client behavior change and health outcomes. The course culminates in a 10-step roadmap with one end goal—obesity fitness specialists who can help their clients reduce their risk of obesity-related risk factors and associated disease, discover the joy of movement, and reap the many health benefits of physical activity. 

People with obesity who find health & fitness environments where they feel welcome and included are likely to stay. Fitness specialists who are able to lead with empathy and build trust are likely to make their clients feel understood and heard. Obesity Fitness Specialists have an important role to play in helping their clients with obesity achieve their health & fitness goals.

Dr. Amy Bantham, DrPH, MS, MPP, is the CEO/Founder of Move to Live More, a research and consulting firm addressing physical inactivity, chronic disease and social determinants of health through cross-sector collaboration and innovation. A certified health and wellness coach, personal trainer, and group exercise instructor, Amy holds a Doctor of Public Health from the Harvard School of Public Health. She can be reached at movetolivemore.com or @MovetoLiveMore

man holding woman hand

How Long Does It Take to Recover From a Hip Replacement?

/20 December 2021/ All MFN blog/

In the U.S., approximately 300,000 people undergo a total hip replacement every year, according to Harvard Health Publishing. If you’re preparing to have this common operation, you probably have some questions about the recovery process.

The good news is that you should be able to walk within just a couple of days after the surgery. That said, it usually takes around 10-12 weeks of physical therapy before you’ll be fully ready to resume your usual daily routines.

Conditions that May Require a Hip Replacement

The hip is the body’s largest joint, and it goes through natural wear-and-tear over the years. As the joint degrades, it may become necessary to replace damaged sections with artificial parts called prostheses that are typically made from metal, ceramic, or hard plastic.

Arthritis associated with aging is the most common reason why people get hip replacements. While living well with arthritis is possible in some cases, sometimes surgical intervention becomes necessary.

In addition to osteoarthritis and rheumatoid arthritis, osteonecrosis is another condition that may lead to hip joint damage. Patients who suffer from osteonecrosis don’t receive enough blood flow to the hip joint’s ball segment which leads to bone damage.

Symptoms that May Necessitate a Hip Replacement

As people age, it’s normal to experience aches and pains. If the pain becomes too intense and/or persistent regardless of pain medications, it may be necessary to get a hip replacement. You may also need a hip replacement if you’re struggling to walk even with the aid of a walker or cane, if you aren’t able to climb stairs, or if the pain makes it difficult to sleep.

The Road to Recovery

Everyone recovers in their own time, so you may heal faster or slower than other patients. According to WebMD, here’s what a typical recovery from hip replacement surgery looks like:

Days 1-2: In some cases, you may be able to start some light physical therapy the same day as the surgery. If you’re not ready the same day, you’ll start the following day. At this time, you’ll probably be on IV pain medications and following a liquid diet.

Days 3-4: After a few days, you should be able to walk carefully with the aid of a walker or crutches. You should be able to take pain pills instead of IV pain medications and eat solid foods.

Days 4-5: Depending on how you’re feeling and performing, you may be able to move from the hospital to your preferred place of recovery. While some patients may be able to go home at this time, others may need to stay at a rehab center for ongoing therapy.

Days 5+: After five days or so, you will need to keep performing physical therapy exercises and care for the point of incision. If you’re staying at a rehab center, they will handle everything. If you’re recovering at home, you may want to have a private duty nurse visit to ensure proper care.

Days 10-14: By the two-week mark, you should be able to stop taking pain medications. You may need to have your stitches removed if they’re not the type of stitches that dissolve on their own. You should be able to bathe or shower around this time (talk to your doctor first).

Weeks 3-6: After approximately three weeks, you should be able to handle light activities, although there may be a bit of residual soreness, especially during the evenings. You should be able to drive again after six weeks.

Weeks 10-12: By this time, you should feel fairly normal. While there may be a small amount of pain or swelling, you should be able to resume regular pre-surgery activities. You may still need to have follow-up visits with your doctor for around one year after the surgery.

How to Prepare

If you’re considering a hip replacement, the first step is to see an orthopedic surgeon who will examine you and inquire about your medical history and any medications you might be taking. The surgeon may recommend x-rays, blood tests, and an MRI.

If the surgeon determines that a hip replacement is the correct course of action, medical professionals will guide you on the next steps you’ll need to take.

Planning Your Recovery

At this time, it’s important that you prepare for your post-op recovery. If you plan on recovering at home, it’s essential that you make your house habitable. For example, you won’t be able to climb stairs while recovering, so you will need to make appropriate accommodations.

Working with an educated fitness professional after your hip replacement may also help accelerate your recovery after surgery. While it may seem counterintuitive to use your hip after surgery, post-joint replacement exercise can actually aid postoperative recovery by rebuilding the strength of tendons, muscles, and ligaments around your hip joint. By working with a physical therapy or fitness professional, you also help:

  • Reduce the risk of clotting after surgery.
  • Reduce swelling and fluid build-up around the surgical site.
  • Accelerate the time it takes for you to get back to normal activities.
  • Build strength and restore normal movement.

Because recovering from a hip replacement usually requires professional assistance, many patients also choose to book a stay at a dedicated treatment facility for the first 48-hours to week after their procedure. This allows them to recover surrounded by healthcare professionals who can keep them comfortable while also providing patient-specific guidance.

You Deserve to Feel Your Best

It’s no secret that surgery can be stressful, but staying at the right recovery center can go a long way in making this journey a positive experience in the long run. The key is to plan your recovery in advance so you can focus on healing when the time comes.

A hip replacement is a positive step towards a happier and healthier life. While the prospect of surgery can be daunting, try to remember that the procedure is extremely common. You deserve to feel your best, so don’t hesitate to get in touch with your doctor if you feel like a hip replacement could be the right decision.

Isabella Koretz, Founder & CEO of Pearl Recovery Retreat and Ciel Spa, has been an entrepreneur and businesswoman for over a decade. Her experience in the healthcare industry is vast and she understands both the medical professional and patient side of the industry. While her professional endeavors are extensive, she is most proud of her role as a loving wife and a mother of two beautiful children.

References:

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Using a Lifestyle Medicine Approach to Support Health

/17 December 2021/ All MFN blog/

The American College of Lifestyle Medicine (ACLM) defines lifestyle medicine as an approach to prevent, treat, and sometimes reverse chronic diseases to promote optimal health. Individuals are encouraged to follow a healthy eating pattern that is predominantly plant-based, engage in regular physical activity, experience restorative sleep, manage stress with success, avoid risky substances, and engage in positive social connections. There are a variety of tools and strategies that medical, health, and fitness professionals can utilize to have a collaborative conversation with clients and/or patients that can evoke change. It is useful to have a structured framework to facilitate the conversation.

Using the 5 A’s Framework to Structure the Conversation

Many medical providers and personal trainers have not been trained to facilitate a conversation surrounding an individual’s desire and readiness to change. This is a useful tool for structuring the conversation and ultimately setting SMART goals if the client or patient is indeed ready to commit to making a change.1

Assess
To begin the conversation, ask if the patient is currently engaging in the healthy behavior that is being contemplated as well as exploring their feelings about this specific health behavior. This dialogue will give you some insight about current beliefs and behaviors as well as identifying any gaps in their knowledge.

Advise
Here you can put on your expert hat and provide the individual with evidence-based information that highlights the benefits of making a health behavior change. If your client or patient is receptive, now is the time to provide them with specific strategies or a prescription.  For example, if they are looking to lose weight, you could prescribe a combination of cardiovascular and muscle strengthening exercises to support that goal.

Agree
As the conversation continues, collaboratively work to identify goals based on where they are showing interest and energy as well as where they have confidence in their ability to successfully make a sustainable change.  In this part of the conversation, you can help your client and/or patient create a SMART goal that is relevant and aligns with their values to promote self-efficacy.  

Assist
It is now time to discuss potential barriers and explore strategies that could be helpful in overcoming these challenges. This is also an opportunity to discuss social and environmental support structures that have the capacity to promote accountability and ultimately lead to self-monitoring.  

Arrange
As the conversation draws to a close, arrange a follow-up visit to monitor progress and convey that you are there to provide motivation, accountability, and support.  This is also an opportunity to refer your client and/or patient to community resources or to other health, fitness, or nutrition professionals that can support the behavior change process.

Redefine Health with Lifestyle Medicine

Using a lifestyle medicine approach highlights the need to promote optimal health by addressing health behaviors across the dimensions of wellness. This approach has the capacity to prioritize mental health as it is integrally related to our physical health and impacts our relationships with others. Lifestyle medicine is an emerging field that prioritizes our conversations with clients and patients creating rapport and trust that ultimately enables them to experiment with behavior change.  Health coaching and lifestyle medicine are a powerful combination used in delivering evidence-based interventions that have the capacity to help others redefine their health.

Suzanne Stringer, Master of Health Science, CHES, CHC, CPT is a health coach and personal trainer. She collaborates with clients to co-create goals that enable them to experience success as they work through the behavior change process. Additionally, Suzanne is an adjunct faculty member in the Health Sciences Department at AACC.


References

  1. American College of Lifestyle Medicine.  (2021).  Foundations of Lifestyle Medicine Board Review Manual.  American College of Lifestyle Medicine.  

 

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Living With Purpose: A Challenge Fear Can Sabotage

/9 December 2021/ All MFN blog/

I find the holiday season to be challenging mentally, emotionally and physically. I am sure many of you who are reading these words feel a similar pressure of the current year ending – and the uncertainty of the new one to come. During this time of the year I have found myself being repeatedly burdened by entertaining old, worn out, negative thinking which leaves me exhausted and prone to getting sick, frustrated and fearful of the unknown time ahead.


The mind-body connection

This year it has been no different for me as I seem to be facing a past challenge regarding my belief in myself, my self-worth – and my purpose. For the better part of the last week and a half I have been struggling with a bad case of what I believe is the flu. With this latest (rare) bout of illness I have been blessed with a large dose of coughing, sneezing, general weakness and a very substantial lethargy. I believe in the power of the mind to bring us health and well-being but I also believe our thoughts (and beliefs) can – and do – deliver to us the other side of life which includes illness, unease, a genuine lack of self-confidence, and a sense of what I will call “hopelessness” – a feeling of living without purpose.

This is how I have started to feel in December – that regardless of what I have done, written or spoken about in terms of my passion for healthy aging, that it matters little and that I am wasting my time. This thought has occurred to me many times before and I am sharing it with you now because I am going through this challenge in this moment in time. ALL of us at some point in our life (and in my case it has been more than once) have felt empty inside and afraid – fearful of the unknown, of not being enough, of having chosen our path in life badly – and much more “baggage” that we carry around with us every day! It is a burden we decide to carry. It is up to each of us to decide to stop carrying this extra weight – or it will remain a “drag” on our life well into the future! We don’t need negative thought patterns ruining our lives, do we?

Fighting negative thoughts

The point is that it takes courage and discipline to “fight” this negative “wave” of feelings and thoughts. The first step that we can take to address this important issue is to become AWARE that it is happening – and to STOP and THINK in order to increase the possibility of changing your mind in order to “reassert” your power over your training – but your life as well. I am grateful for these reminders as they spur me to make the choice again that I AM valuable and worthy of success. Even at 70, I am dealing with this very issue as Christmas approaches – again. I had a terrible Thanksgiving because I could not be with my daughter and grandson and tonight had a harsh exchange of words with her over the phone (frustration, anger, fear – whatever it may be.)

What this matter basically comes down to is a FIRM belief in ourselves – and our own unique purpose – that we are alive for a reason. It is incumbent upon each of us to maintain a vigilant and forceful awareness that CAN prevent negative thoughts from derailing our dreams from becoming fully realized. If we allow these negative thought patterns to remain in our subconscious minds over time they WILL harm us emotionally, mentally and physically. ALL life – and reality – begins with thought, so guard your thoughts well! I am sorry to report that we are never done with these challenges of the mind and they can – and DO repeat (sometimes – not always) for a reason: To REMIND us of who we are – and are becoming. The ego wants to regain control of our thought patterns and return us to an earlier status quo that never worked for us – and never will.

The antidote for this negative “cycle of thought” is an examination of what we are doing and how well we are doing it. Can we improve our behavior? Our discipline? Our planning? Our listening? What is it that we are seeing again – and why? My conversation (argument) with my daughter showed me I am still capable of entertaining past negative thinking with poor results showing up again in my life. What a DRAG! Low self-worth and self-esteem can raise doubt and fear in all of us. What I am experiencing right now is a reminder of the road I have travelled – and the miles I have to go. It is always incumbent upon each of us to be “self aware” and allow this awareness to guide us to take personal responsibility for our behavior – and thoughts – (all that any of us can control  and then, and only then, will we make it successfully to our goal and accomplish our mission.

Our fitness programming follows this same logic and if we believe we cannot make it – we won’t. Our thoughts determine our results and our belief systems determine everything else of importance in our lives. DON’T LET FEAR AND SELF DOUBT control your future destiny. DO NOT entertain thoughts that in and of themselves are self destructive. I don’t know how the distance with my daughter will be bridged before Christmas but it will probably include compromise and some serious mutual listening.

Conflict in itself solves NOTHING but it CAN promote growth and understanding so I am not shy about engaging in a good argument – if it leads to greater mutual understanding – and peace. It is in HOW we disagree that matters. I argue with my feelings leading the way sometimes and that CAN be hurtful, but in this hurting we may get the opportunity to expand our definition of ourselves – and expand our consciousness as well. This is what I would call a “win – win”. This potential outcome CAN help us grow into a new definition of ourselves and create new opportunities with those we love – and with those others we value in our lives. It is about taking some risk and exposing ourselves to being uncomfortable for a while. I feel it is worth the effort – just be smart about how you go about implementing this idea!

I am convinced this time of year is challenging for all of us because there is much we need to learn – not only about ourselves – but about each other as well. After 45 years of being a father I am still learning about what that means and tonight I found out I am still NOT as patient or compassionate as I thought I was and so some “soul searching” will be required to bring me back to my best path of growth and understanding with those I love.


Take time today to reflect not only on your relationship with yourself but also with those you love and care about and see what emerges. You might be in for some amazing surprises and only YOU can do this work. Becoming a thoughtful listener is really the key to effective communication so practice that skill a lot! We have TWO ears and ONE mouth for a reason. I really find the holiday season to be about buying “STUFF” and not about appreciating our many blessings. This thought drives me crazy! However, this is the life we are living today so I either learn to live with it creatively or I will continue to hit the same “brick wall” as I have in the past – and I CHOOSE NOT DO THAT. All of this is to say that becoming unsettled, confused – or even angry – is probably a sign that we ARE ready for positive change to enter our lives and I TRULY BELIEVE that is a VERY good thing! Travel well.

Originally printed on HealthyNewAge.com. Reprinted with permission from Nicholas Prukop.

Nicholas Prukop is an ACE Certified Personal Trainer & a Health Coach, a fitness professional with over 25 years of experience whose passion for health and fitness comes from his boyhood in Hawaii where he grew up a swimmer on Maui. He found his calling in writing his first book “Healthy Aging & You: Your Journey to Becoming Happy, Healthy & Fit” and since then he has dedicated himself to empowering, inspiring and enabling people of all ages to reach for the best that is within them and become who they are meant to be – happy, healthy and fit – and be a part of a world where each person can contribute their own unique gifts to life.