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Doctor battles obesity with short bursts of exercise

Editor’s note: This column by Dr. Christopher Lillis will appear in the Healthy Living section on March 11, 2012.


Confession time: I am 38 years old and weigh 239 pounds.  At 5 feet 11 inches, I have a Body Mass Index (BMI) of 33.  I am obese, and yet I speak with my patients every day about healthy eating, exercise and losing weight.

This advice has been personally very difficult to follow.

The last time I was at a normal weight, according to BMI standards, I was 25 years old and weighed 185 pounds—on the day I ran my first marathon.

I know how I got to be obese, and my story is likely similar to the stories of the more than 36 percent of Americans who also are obese.

With obesity, I see my patients get caught up in self-loathing and the blame game.  Many who are obese are very sensitive about their weight.  But what is most important is not blame, but solving the problem.

Fortunately, I have a new strategy for tackling the problem, as well as some insights into why the battle is so tough.


The roots to rising obesity likely began with the industrial revolution, when machines increasingly replaced manual labor.  As we moved from an agricultural economy to a more modern one, physical labor became less and less needed.

The really brisk acceleration in the national obesity rate took place in the last 30–40 years.  We simply started walking less as more of us moved to the suburbs and took on long commutes.

And with restaurants  catering to our taste buds, we now consume more calories per day than the entire rest of the world.  The average American  consumes 3,600 calories per day, while our metabolic needs are about half of that. In parts of Africa and Asia where poverty is greatest, average daily calorie consumption is less than 1,600 calories per day.


For much of human history, starvation—rather than obesity—was a potentially fatal concern.  Evolution has left us with physiologic resistances to losing weight.  A cascade of hormones  influence our fat deposition, appetite and metabolism.

An excellent book called the “The Evolution of Obesity” by Dr. Michael Power and Dr. Jay Schulkin details the complex mechanisms inside of us that favor weight gain over weight loss.

Between nature and nurture, we fight against incredible head winds to maintain a healthy weight.  This is why I refuse to allow my patients to call themselves “fat” or look down on themselves (and why I try hard not to judge myself, either). Judgment and name-calling, even with ourselves, often interferes with reaching our weight loss goals.


Finding a sustainable diet can be difficulty in our current environment, but I would strongly encourage you to prepare your own foods. By taking the time to prepare your own foods, you are better able to avoid so many of the hidden calories we get from restaurants and processed foods.

However, exercise is the key ingredient in weight loss and weight maintenance. This has been my greatest personal struggle, and it is often the critical component missing in my patients’ lives.

When I was in college, I played two hours of pickup basketball every night.  In medical school, I ran my first of two marathons.

There was a precipitous drop in my exercise as the long hours of residency training gave me excuses to de-prioritize exercise, and my current excuses include spending time in my busy practice and with my family.

But there is hope.


This past Valentine’s Day, my practice partner Dr. Lynne Clemo proposed a challenge: try to perform 10 pushups in between every patient we see in the office. While this sounds pretty simple, we have found the idea to be revolutionary!

We wondered: What if we performed simple exercises every day in the office in between patients?

Dr. Clemo is an elite athlete.  She has run innumerable marathons and triathalons, is a member of the Fredericksburg Area Running Club and participates in Crossfit as well. She has been working with a local personal trainer, Trish Blackwell, and with some brainstorming, we now have a plan: the Workplace Movement Challenge.

Since Valentine’s Day, Dr. Clemo or Dr. Hong Nguyen has chosen a single exercise for the day.  It may be pushups, squats, lunges or sit-ups.  There is almost no exercise equipment in our office—most is done just with the help of our bodies and gravity.

The plan has proven sustainable and enjoyable.  Our office employees look forward to the daily exercise, and everyone has been losing weight and feeling more energetic.

Urge your office to take up the Workplace Movement Challenge. Visit the website today to learn about the exercises you can easily perform while at work.

Nominate someone in the office to be in charge—a “fitness champion.”  You and your coworkers can motivate one another and build exercise into your day no matter what kind of commute you have.


By performing these exercises throughout your day—perhaps a short set once an hour—you can burn 200-300 extra calories every day.  This yields 48,000 calories burned in a typical year!

 To lose a pound of fat, you need to burn 3,500 calories, so you can expect to lose 14 pounds every year with this program so long as you are eating a healthy diet.  A healthy diet includes between 1,800-2,400 calories per day, depending on your age, sex and weight.

We all need to move beyond the boom and bust of New Year’s resolutions and fads.  Sustainability is the key to maintaining a healthy weight.  Avoid harsh judgement and blame, as these will only impede your goals.

We need to rethink how to shake up our sedentary lifestyles, and where better to start than the place you spend close to 2,000 hours per year?

Dr. Christopher Lillis can be reached  at healthyliving@freelance