Last Updated: March 31, 2015
I often see overweight or obese patients who appear very frustrated that exercise is not working for them. When asked to elaborate, they usually tell stories of short walks around the neighborhood or with the family dog.This article aims to shed some light on this issue. Rather than using abstract/technical concepts, I am going to use the example of my 86 year-old father.
Our bodies are amazingly efficient machines. An average sized adult can walk for almost half an hour burning only the equivalent energy found in a medium sized apple. A slice of apple pie? Six times more calories! You do the math...
For millennia, men and women have done A LOT more physical activity, on a daily basis, than the average person has to do today. It was not a choice, it had to be done. I was fortunate enough to grow up, for a good portion of my early life, in rural Romania, where life was - and still is - quite similar to what it was 100 or even 1,000 years ago. I will illustrate this with a few pictures I took of my father during a recent trip there.
My father is 86 years old. He lives in a village in Eastern Romania, at the foothills of the Carpathian mountains. He and Mom have a garden, a cow and some hens and other small birds. My dad is also an expert beekeeper, and has a number of beehives around the house. They grown their own food, for the most part.
His daily routine varies with the seasons. What I describe here is what he typically does on an early Spring day.
He wakes up quite early in the morning, just in time to hear the cow's insistent "Mooos", a clear indication she wants breakfast.
Cow "breakfast" at this time of the year involves a large pile of hay, carried with a fork over a good 30 feet, and a couple of buckets of water, each weighing at least 20 lbs. All of these items are carried by hand, as you can see in the image below:
A little later, the cow needs to be milked. Manually. I don't know if you ever milked a cow, but if you didn't, you should know that it involves one of the most strenuous workouts of the forearm and hand muscles I've ever experienced. Especially milking a cow that makes 20+ liters of milk a day, like my parents' cow does.
Making that much milk requires a lot of food. And a lot of water. At least 10 buckets a day. All hand-carried over a distance of at least 100 feet.
Last but not least, there is a lot of cow dung that needs to be taken care of. My Dad loads the manure into a wheelbarrow every day, and then pushes it through the front yard and then across the street all the way to a garden where they use it as fertilizer.
And so far he only took care of the cow. As I told you, he is an avid beekeeper, and most days he spends a fair amount of time checking on them. On this late March day, I took a video of him opening a beehive to see how the bees were doing. The reason I embedded this video here is that it illustrates very well, I think, the fact that staying in physical shape over the years has helped my father preserve his fine motor skills almost intact. Otherwise, it would be very difficult to move those frames full of bees in and out of the beehive, in the little space available, without crushing or angering a lot of them in the process.
Bees make honey, and honey is heavy. Very heavy! Here is a picture of Dad with a small barrel of honey. "Small" is a misnomer here, because this thing is heavy! It feels like lead! But he is still able to move it around and even carry it up a flight of stairs when needed.
He also spent some time wiring frames for the new season:
On the day I took these pictures, he also rode his bike for about 4 miles to pick up some medication for my mom from the local pharmacy. Overall, he spends at least 5 hours outdoors every day, unless the weather is inclement.
All in all, I estimate he burned well over 500 calories on that day. Which is a typical day for him. For comparison, if I manage to motivate an overweight patient to burn 200 calories a day, on a consistent basis, I consider it a big success!
The point I'm trying to make here is not that we should all return to my Dad's way of living, although it has its advantages, and as I said in the beginning, I consider myself privileged to have been able to experience it a bit, in my earlier years. Neither am I trying to brag about my Dad and cast a disrespectful light on people who exercise less - though I will say that he is in better physical shape than many patients I see that are 30, 40 or even 50 years younger. I am not even trying to set him up as an example for others - I actually think he is overdoing it.
I am simply trying to illustrate the fact that we have been designed for a lot more physical activity than most of us are engaging in, and if we want to lose weight, we need to become realistic in order to see meaningful results. Our modern, sometimes too artificial life makes exercise optional. We drive everywhere. We park as close to the entrance as possible. Some of us even use motorized shopping carts, despite being able to walk, and in spite of our bodies craving physical activity. Our kids spend hours every day looking at screens of various sizes and resolutions, and don't enjoy running and playing outside anymore. We eat a lot more and move a lot less than our predecessors. We sleep less, we are more stressed, and we have no time to enjoy the simple pleasures of life and nature. And, in the process, we gain a lot of extra weight.
If you are looking for ways to exercise for weight loss, you need to be willing to go beyond a casual, occasional walk in the park... 10,000+ steps a day, or another equivalent exercise, is a good start. Unless somebody comes up with a way to make our mitochondria a lot less efficient, but I would not keep my fingers crossed :-).
One last word about my Dad. When I went to visit him and Mom, I wasn't sure what to expect, as it had been several good years since I last saw them. I was pleasantly surprised to find them physically stronger and in better spirits than I hoped. And I know he will continue to stay active for as long as he lives.
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