My Only New Year's Resolution for 2012

Every year, I make the intention to work harder and do more in some way, and I often succeed. Last year, I made three resolutions and completed two of them.  But there is one thing that I have never been able to be successful at making any resolutions about (New Year’s or otherwise) and that is perhaps the most common resolution of all: losing weight.

As I wrote in my latest post on Doctors for America, there are many reasons why losing weight is difficult. Our bodies are built to preserve the weight we gain; so, even if we do succeed in losing a few pounds, we are biologically queued to do all we can to go back to the higher weight. Furthermore, fundamentally, as anyone who has ever watched the Biggest Loser realizes, the whole trifecta that leads to better health — weight loss, exercise, eating better — is not just a matter of hitting some short-term goal but a redefining of the environment that we live in.

As doctors and doctors-to-be, we often speak about “lifestyle change” as if it is something we can just write on a prescription pad or institute with a new health insurance policy, without breaking down the words and realizing that we are asking people to change their lives. We’re sweeping under the rug the fact that it is much harder to lose weight (involves eating much fewer calories and exercising much more) than to maintain a weight you’re already at. In the process, we’re stigmatizing our own patients for being lazy and weak-willed.

This unhealthy focus on unsustainable weight loss needs to stop. So, in my own quest for lifestyle change in order to achieve better health, I am simply focusing in on one thing: to develop a habit of exercise.

Here are five reasons why:

  1. As a future physician, I want to know what I’m talking about when I ask people to change their lifestyles to promote their health. I can learn about the pathophysiology of disease in class, but I can only imagine how much each illness impacts the daily habits of those who have to live with the disease. I already barely manage to keep track of the few medications that I have to take as a relatively healthy 20-something, how can I know how each of my patient’s diseases affect their individual lives? This small change in my life is common enough compared to a new diagnosis of diabetes, but by taking small baby steps to change my own life, perhaps I will have some better sense of how to counsel my patients to change theirs.
  2. **By focusing on exercise, I am concentrating my energy on a behavior that I can change as opposed to a biology that I can’t change. **As I alluded to above, the benefits of losing weight are rife with controversy, cultural biases and poorly-understood biology. How to we disentangle losing weight to be healthy from our cultural obsession to be thin and societal inability to acknowledge that perhaps everyone may have a different “healthy weight”? I’m still not sure how to confront all these issues for my future patients and myself, but I do know that the evidence that regular exercise is good for your health is pretty unequivocal. Perhaps most importantly, regular exercise is based on behavior that I can control rather than biological factors that I have no control over. **
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  3. Given my current schedule, I am more sedentary than ever before, making exercise a greater need than ever before. I have never liked to exercise, but have gotten away with not exercising by generally eating healthy and staying active in my regular lifestyle. This was easy to do when I lived in a walk-up apartment, did not own a car, and walked to class every day. Now, I have a car, an elevator building, and instead of having time between classes and going home, I am in class for far too many hours a day to even think about going for a walk between activities (thanks med school). As a recent study in the American Heart Association’s journal showed, even when you control for things like what people eat and how much they exercise, every extra hour of sitting (to watch television) substantially increases the risk of cardiovascular disease and mortality. Therefore, I have to do something to counteract the amount of time I spend sitting in class and studying, whether I like it or not.
  4. ****By making it a habit, I can insure that I actually make exercise into a priority. Medical school already comes with a pretty full schedule, which only gets worse as the years go along. Though I have seen classmates who enjoy exercise being able to fit it in after school or during lunch, I know that I would need to do something more drastic in order to fit something into my schedule that a) I’m not used to and b) I don’t like much. If I have to perpetually reschedule my exercise around lunch talks and evening meetings, it simply won’t happen. So, this night owl is getting up earlier every day just to make sure I make this new habit happen.
  5. **By focusing on this one thing to change about my lifestyle, I can better track my progress and ensure success. I’ve started reading Leo Babauta’s Zen Habits for inspiration in staring my exercise habit, and while I certainly don’t follow all of his advice on habit change, I do take seriously his admonishment to smart small and to start with one thing. I am one of those people who will try to do lots of things  at once and only get some of them done, but to change something that I have so much internal resistance on, I need to focus in and take this seriously. I may not be able to run a marathon at the end of the year or get any strength training in as a result of this, but I will be able to make a bigger difference in my life in the long run by making a more lasting change.
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So, at least six days out of the week, I am endeavoring to get up early in the morning to hit the elliptical or (weather permitting) go run along the Lake Shore Path. I’m on my third week now, and I’m proud to say that I’ve only missed a couple days so far (one because we were going skiing, which I feel fulfilled my exercise requirement of the day and another because my alarm didn’t go off). Given how short my runs have to be, I don’t foresee this making a dent on my waistline, and there are no sign of any endorphins yet. However, I am already feeling more energetic on the days I do manage to get a good run in, and am slowly but surely seeing improvements in my cardiovascular fitness level / ability to run.

Further Reading (new section I’m adding for the new year because I hate doing link-only posts but there are definitely so many related links to share!)

  • Weight Loss and New Year’s — my post over at Doctors for America, in which I go over some of the latest news on weight loss and reflect on how we should apply this information to treating our patients
  • A Compact Guide to Creating the Fitness Habit — latest post on the subject by Leo Babuauta over at Zen Habits
  • Weight loss posts from Dr. Jen Gunter’s blog — Dr. Gunter is an inspiration for many reasons, but one of those has been her public chronicling of her (evidence-based!) work at losing weight. She has lost 45 pounds in the past year, maintains a calorie count of 1400 a day and I think goes into the gym for boot camp and running multiple times a day. Along the way, she has shared numerous tips from her experience and the latest in evidence-based medicine on the issue. Quite the worthwhile read.
  • Running out of excuses — great post from another one of my favorite doctor bloggers on her running inspirations and her own attempts of getting into running.
  • Too Much Sitting is Killing Us — coverage of the *Circulation *paper on how watching TV increases cardiovascular risk

Photo credit: Stefan Lins on Flickr