Deborah Messick doesn't need to find her motivation before she goes to the gym -- her motivation is waiting for her.
Personal trainer Dolly Kanstrup at Powerhouse Aerobics and Fitness keeps Mrs. Messick on her toes and worked her back into shape after she had her first child in 1999. But like many people at New Year's, Mrs. Messick has a goal of working off some additional pounds this year. Doctors and fitness experts say making that fitness vow stick means starting slow, having realistic goals and getting back on track after the inevitable lapse.
The need could not be greater -- more than 80 percent of Americans do not exercise enough to get the health benefits, said Stephanie Bailey, lab services coordinator for Health Central. And with obesity at epidemic levels in the United States, health officials from Surgeon General David Satcher to the Centers for Disease Control and Prevention to state and local exercise advocates such as Mrs. Bailey are emphasizing that moderate exercise can make a difference. That translates to at least 30 minutes of even less vigorous activity, such as walking or even gardening, three to five times a week, with resistance exercise or strength training two to three times a week.
The key is commitment, experts said.
"They have to have really made up their minds they're going to do it and make it a part of their lives," said orthopedic surgeon Dr. Robert Brand of Doctors Hospital Center for Sports Medicine.
And there are new tools for assessing just how prepared the clients are for change, such as the Dr. James O. Prochaska Transtheoretical Model for the stages of change.
"This helps us look at a client and say where are you on a continuum of being ready to make a change, essentially putting exercise into their daily routine as a behavior change," Mrs. Bailey said.
Ms. Kanstrup uses a nine-page questionnaire not only to assess clients but also to help them examine their lives, she said.
And for those doing their own resolutions, Mrs. Bailey advises a written plan, with specific but realistic goals, such as increasing exercise or activity month by month throughout the year.
The key is being realistic, said Diane Smith, clinical nutritionist with CSRA Partners in Health.
"People follow their resolutions for a few days and then they give up," Dr. Smith said. "There's that mentality of, `Well, I blew it, so there's no point in continuing to try."'
That's why it is important to plan ahead for those inevitable lapses, Mrs. Bailey said, and spell out how to get back into the program.
People also can defeat themselves by choosing something they will not enjoy, said Robert Gambrell, director of primary care sports medicine at Medical College of Georgia Center for Sports Medicine.
"They go out and buy the exercise machine without trying it out first and then it becomes a coat rack," Dr. Gambrell said.
"A lot of people think they have to get out and run to get these benefits or they have to chain themselves to the Stairmaster," Mrs. Bailey said. "There is a wide variety of activities to choose from. A lot of people think if they're having fun, it can't be exercise, so they don't count things like square-dancing or Rollerblading or biking outside."
Or they don't start slowly -- as everyone advises -- and work up to a reasonable goal, Dr. Brand said. That lands them in his office.
"(People) who jump in too quickly, especially middle-age people who don't start off with the proper stretching first," Dr. Brand said. Even if the activity is walking, it is important to do gentle stretching before and after so muscles don't tighten up, he added.
For many people the barrier is time, but, here again, it can be more flexible than people think, Mrs. Bailey said. Moderate exercise for 8 to 10 minutes, raising the heart rate between 60 and 90 percent of maximum capacity, can improve health, allowing someone to work out at shorter periods different times during the day, Mrs. Bailey said. It could mean walking during a lunch break, then walking before you leave work or at home. Exercising in the morning works for many busy people, such as Dr. Gambrell, because things that could interfere tend to come up later in the day, he said.
For some, the need to exercise is not a choice. After a heart attack three years ago and then developing congestive heart failure, John Holden, 63, went through cardiac rehabilitation at University Hospital and then finished up at Health Central. Nearly a year later, he is still sticking to his routine of working out every day.
"Once you start the routine, you miss it," Mr. Holden said. "Your body feels so much better when you do come and do it every day."
Getting back into shape with the help of Ms. Kanstrup is something Mrs. Messick does not only to look better but also to feel better.
"You start to notice at 30 you don't have that 20-year-old body anymore," Mrs. Messick said. "That'll get you going."
But more it is how the workouts carry her through the day.
"I think it gives you energy the rest of the day," Mrs. Messick said.
And, it is hoped, much longer, Ms. Kanstrup said.
"We have a choice," she said. "Either we get up and decide we're going to be participants or we're going to sit in a rocking chair and watch it go by."
Reach Tom Corwin at (706) 823-3213 or firstname.lastname@example.org.
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