MS and Exercise and Weight Loss

Ok here's another challenge that I MUST conquer.

Like about 80% or more people with MS my biggest enemy is chronic fatigue.  So how do I manage to do a regular, effective, workout where I don't have to bail out half way through for a nap and that will actually result in weight-loss. Any advice or resource suggestions?

Amy

[teenyturner]

I've been told I'm not to exert myself....well, I can't anyway, just trying to walk to the mailbox takes as much effort as when I used to run 5 kilometers before work.

So,  I've put on heaps of weight and I think this makes my mobility worse.  It's a vicious circle.  I went and saw a bariatric surgeon who said that I'm not overweight enough to qualify for a gastric sleeve operation but because of my physical condition he would consider doing the surgery anyway.  I have another appointment to see him at the end of January. I know it will take longer for me to recover and will initially worsen my symptoms but I still desperately want this surgery.  Not only will it be easier to mobilize if I'm lighter but if/when I need someone to help me with things like showering and toiling it will be easier for them too.

If MS is anything like my condition I think getting enough exercise without worsening your symptoms is a very difficult problem.

Regards

[jensequitur]

The first thing to do is figure out how many calories you need at minimum, with no exertion.  Plan out your diet so that your intake stays around that amount.  

Next, you should figure out when you're feeling most energetic.  If you're like me, that's around 8:00 pm.  Then it's just a matter of what you want to spend your energy on - cardio or weight lifting.  They say now that you can spend the same amount of time weight lifting as with cardio, and you'll get the same health benefits.  I'm so used to the old-school exercise regimen - 30 minutes of cardio, then lifting weights for 30 - that I feel like I'm slacking off if I don't do that.

Also remember that weak muscles from the disease process won't be strengthened by weight lifting.  I would stay away from the problem areas, and concentrate on the areas that still have strength.  For example, my right leg is really weak, so I don't do leg lifts or calf raises any more.

[jensequitur]

Oh, I should say that if you do get enough energy to go work out, then you can think about a little more calorie intake.  Stick with the whole grains and fruits!

[kerrtelli]

I do an ms water aerobics class twice a week unless I'm in a flare.
It's hard but since I can't do any kind of physical exercise outside of the water becuase of my obility problems exercising imager works best.

I go to the YMCA.

[Lulu54]

Amy, start out small with tiny amounts of time and gradually work toward more.  Talk to your doctor and ask for a referral to PT to help design a reasonable program for you to do at home on your own.  

Jensequitir is so right too - the only way we really lose weight is if we take in fewer calories.

Please discuss all of this with your GP and maybe even ask for a referral to a nutrition specialist who can help evaluate your food intake.

It isn't easy, but it is worth your while to give it all a try.


Lulu

[maxthecat9196]

My left leg stops completely stops working after about 5 min.  Can this be overcome too?

Tammy

[doublevision1]

My MS nurse advised me to break up my exercise sessions to 3 or 4 x 10 minute sessions throughout the day vs going hard for 30-40 minutes without a break.  I'm off work right now so this is easier to accomplish.  Apparently there is research that says the benefits are the same either way.  

I mainly just do treadmill but I know I need to get back to some strength training.  We have the equipment so I really have no excuse.  

I've also been talking to an old friend via FB who is now a yoga instructor.  He gave me lots of good suggestions and encouragment to get started on a program.  I've never stuck with it in the past but really need to as I need to work on my balance and flexibility.  Yoga can address so many MS related issues and doesn't cause the overheating problem to the same degree as aerobic exercise, just can't do a hot yoga class.  I actually have a book callesd Yoga & MS or MS & Yoga to get me started though what I really need is a DVD and I'm researching currently researching what might suit me best.  I'll let you know how I make out if you have any interest in trying yoga.

And sadly, jen is right.  The less we move, the fewer calories we need.  To incorporate eercise that burns 500 cals/day plus cutting back on 500 cals/day (if there's room in your diet to scale back that much), that's 1,000/day and a 2 lb weight loss per week.  But even at a normal healthy weight, exercise is still so necessary to keep us moving and to stave off some of the ill effects of our disease, our medications, and aging.

[Jacksmom516]

I am battling this demon as well on top of this I am Hypothyroid so I already only take in 1000-1200 calories a day with my limited mobility it is awful -  I am hoping that now I am starting PT I can increase mobility and get moving more - My neuro suggested Yoga and Pilates as it is stress relieving as well as stretching and strengthening.

[Sumanadevii]

This problem belongs in the hands of the opening posters doctors...not  what works for other posters.  Some, believe it or not, are unable to do the the type of exercise necessary to burn calories...PERIOD.  To tell the poster to cut calories is dangerous as she may find herself cutting out important nutrition that her body needs.  

Weight lifting?  Not all MSers have the strength to lift weights and it isn't because they are out of shape and not trying to lift the dang things.  Their bodies just are too weak.  Truly, I am sorry the OP brought the subject to the board.  I feel it is placing blame on her for the problem where it should be placed square on the shoulder of MS.

For me exercise to for ONE thing...to keep mobility.  It doesn't burn calories.  Again, cutting calories may not be an option.  That call is for her doctor not us.  

Just my opinion.

[jensequitur]

I have to disagree with you - exercise DOES burn calories.  Don't use exercise to burn the calories that you decided to eat - just don't eat the calories in the first place.

Of course, I'm not advocating that you starve yourself!  That would be silly.  1200 calories a day is the minimum amount of calories that any human being needs.  Those calories should be real calories - fruits, vegetables, protein, whole grains.  

Cardio and weight lifting are also up to the individual patient.  I really do advocate lifting weights if you're going to exercise.  Strengthening the torso can help with many back problems.  Exercising the arms helps to hold you up.  Like I said before, exercise the muscles that work.  If you have a problem with that muscle because of neurological damage, then don't bother - exercise won't help it get stronger.  But exercising the muscles around it will help with the weak muscle.  It'll help with spasticity.  I can't begin to talk about the benefits of regular exercise and weight lifting!

Exercise also helps with constipation, a common complaint among MSers.

I'm not going to blame MS for my weight problem.  I blame my weight problem firmly and squarely where it belongs - on my intake.  I eat too many calories for the amount of calories I burn.  Any responsible person who really intends to lose weight needs to look at their intake and think about their activity level, and start there.  

I've managed to lose 20 pounds in two years by the simple principle of eating less than I want.  I have been so busy in the last couple of years that I rarely get to exercise.  I also have problems with leg weakness and bladder control - anything with impact is a problem.  

So yes, it is possible to lose weight just by cutting your calories.  Just do it responsibly.

[HVAC]

Go slow and be reasonable. I put the goal of 10 pounds a year when I started with the MS. I gradually cut out foods and gradually increased activity. When I was 50 pounds over weight it was a lot harder to lose ten pounds. The next year a bit easier. It helps if your family is on board and junk is just not in the house. People complain when they visit because we have no soda, bread, processed food, etc in the house. Drinking water is a big part of it.

I time my exercise and go home and take a nap because I know I am tired. I also need motivation. For me it is riding the horse which I really enjoy or walking my Service Dog in training Grady. If I do not take Grady to the mall or out to work he gets bored and starts causing mischief at home to tell me so. Even now with me very ill I walked him at the mall today because I know he is frustrated.

I now no longer need to lose weight I just get out to keep moving.

Alex

[Ojibajo]

Thank you for the suggestions. Honestly I haven't had a lot of helpful suggestions from my GP or my Neurologist, but perhaps, I need to ask different or more specific questions.

I did go through PT when I went through my flare last year, but I never thought to ask about a recommendation for an exercise regimen. I think I will try that next time. Thanks for the suggestion.

I was sent to dietitian or a nutritionist (I forget which).  I know what I should and shouldn't eat. I just need to be disciplined enough to stop eating the things that I shouldn't. :)

[Ojibajo]

Thank you for the helpful suggestions. I am trying to be more disciplined about what goes into my mouth and think of it as fuel and nutrition (fruits and veggies, etc)  instead comfort (Pizza, coke, chocolate). I was doing Yoga last year and I think I will start that again as well as starting to add small workouts and increase them as I can tolerate as Lulu suggested. I do have an active dog who I plan to start walking more as the weather permits and a I'll try to drink more water each day as Alex suggested.

[Lulu54]

If you figure the secret to dscipline, please let me know.  I would love to find some to control some of my eating habits, too.

I go back to the idea that no matter how small,  every one of us can do something to exercise.  I'm not talking about busting a gut in the gym with pushups and squats and treadmill running.  But there are simple chair exercises that can be done to work leg muscles, arm muscles and even strnegthening our necks.  Even that little bit of movement helps to send the signals to our brain that release extra beneficial chemicals.

There are resources on the web through most of the pharma sites that give exercise and nutrition tips.  I'll see if I can dig up some of those for you.

good luck,
L

[Sumanadevii]

Ojibajo, I didn't realize Ojibajo was your real name.

And yes, drinking 32 ounces of soda would pack the pounds on you.  I guess I overstepped my bounds in assuming you had already tried cutting calories...especially ones like pure sugar drinks.

Therefore, I agree with the other posters.  Stop eating and using your calories on sweets and begin a diet with fresh fruits and vegetables.  Moving helps too if you are able.

[Sumanadevii]

Oh, I forgot to add, here is my helpful hint.

Do not bring soda into your home.  If you are drinking 32 ounces daily, it is more like an addiction.  So not having it in sight is a good idea.  Replace it with water.  I bet the scale moves and rather quickly!

[Lulu54]

you might look at these sites for some ideas....

Acorda/Ampyra
moveoverms.org
they have exercises, even seated ones that you can do

NMSS - has an exercise video-
http://www.nationalmssociety.org/living-with-multiple-sclerosis/healthy-living/exercise/index.aspx

biogen/tysabri & avonex
http://www.msactivesource.com/ms-diet-and-exercise.xml

[Sumanadevii]

Lulu, any exercises we do will burn calories but not enough calories for 32 ounces of soda per day....especially if we are in a wheelchair.  I assume for those that can move the fatigue of MS might also limit them.  Just saying off sugar will bring her weight down.

[doublevision1]

Here's an article on exercise from the MS Society of Canada.  It's a little repetitive, but might give you some ideas & motivation:

http://mssociety.ca/alberta/active-benefits.htm

"Why Exercise & Be Active"

We all know we should exercise, but sometimes it is hard to get motivated. It can be especially difficult if you have multiple sclerosis (MS), as the number of MS symptoms, including fatigue can be a problem. Also, the MS symptoms you experience can worsen as the body beings to overheat due to exercising or being physically active.

Overheating for most individuals with MS leads to weakness and fatigue, in turn leading to a decreased ability to be physically active. Furthermore it leads to more weakness, fatigue and other health risks associated with inactivity, such as cardiovascular disease, obesity, and type II diabetes for example. There are many benefits to exercising for persons with MS.

Planned exercise (e.g Yoga, Tai Chi, strength training) and daily physical activity (e.g., walking, gardening, household chores):
.Improves strength
•Improves posture
•Improves mobility
•Lessens fatigue
•Improves mood, self-confidence & well-being
•Improves sleep and appetite
•Improves fitness levels
•Improves cognitive functioning
•Improves ‘Quality of Life’
•Prevents over-use injuries
•Creates opportunities for new social outlets
•Decreases chances of secondary illness
•Helps with weight loss and more importantly
•Improves or maintains the level of independence of the person with MS.

Exercise in a group has the added benefit of support from peers. It supplies a reason to get out of the house.

One of the most frequently asked questions are "what kind of exercise or physical activity should I do to improve my condition?" The answer is not so much about what you should be doing, but that you are active NOW! Any type of activity that gets you up and moving has positive benefits for people with MS. Some people go for walks, do yoga or take part in Tai Chi, while others prefer something a little more structured and routine, for example, exercising on a treadmill, stationary bike, or stair climber. Strength training with weights is also great. It doesn’t really matter what you do as long as you are active.

People with MS should bstretch on a daily basis. More specifically stretching of the legs should be done daily. Spasticity or stiffness of the muscles which is common in many people with MS can cause permanent shortening of muscles if stretching is not done. Research has shown that gentle sustained stretches of the legs can help to decrease this stiffness. The benefit of stretching is not seen immediately but will be seen over time. It helps to prevent contractures and changes in the body’s physical structure from affecting movement. By ensuring the legs stretched are worked through a full range of motion, walking for some people with MS becomes less tiring.

Aquatic activities, such as swimming or aquasize represent excellent ways to work the whole body. The water itself is used both for support (buoyancy) and resistance. The amount of resistance created depends on how fast you move and how much effort you put into the action. Many community facilities offer supervised classes for people with disabilities and MS. Most facilities also provide accessible ramps and mechanical lifts so that if you have a mobility issue, you can still access the pool and facility.

Exercise is also equally important to persons with limited or no mobility. For example, deep breathing exercises can help to keep the lungs well ventilated and clear of infections. Gentle sustained stretches should be done daily to maintain the range of motion in the legs and to prevent stiffness and permanent shortening of the muscles. This is especially important for persons who have difficulty or cannot stand or walk.

When we think of being active or having an active life we tend think of planned exercise (i.e., scheduled activity) as the only way to be active. This is not true! Daily physical activity can also have the same benefits for persons with MS as does planned exercise. Daily physical activity consists of non-scheduled activities that get you moving and active. Many of the things we do in our everyday life count as daily physical activity. Here are some examples you can do and try:
-.Going for a walk with friends, family, the dog, or by yourself;
-Household chores;
-gardening; and
-shovelling the driveway.

This is just a small sample of what you can do to be active in your daily life. Take the time to think of other things in your life that may be a way to promote and encourage being active. Again, all that matters is to be active NOW, so you too can enjoy the benefits of being active and in the best shape you can be.

The benefits of planned exercise & daily physical activity in MS are numerous. Improved strength, endurance and even bowel and bladder function are possible, as well as it lessens fatigue and improves mood. There are many options for being active, depending on your interests and abilities. It doesn’t matter what type of MS you have, every individual can find and benefit from the right exercises and activity. Exercising & being active provides an opportunity to take charge of your life and learn to make the most of what you have.  So, get active NOW!"

[heartfelt77]

  I would have to say I totally agree with you.  I can't walk and I'm in a wheelchair but, I do try everyday to move around in any way that I can. I also stretch my legs and arms everyday and it feels great.  I would highly recommend do Aqua therapy for everyone. I've started it and what a difference it has made.   I can also say that awhile being in the water I feel very feel and able to move. Also, it helps with pain at the same time. You feel very relaxed.  

It's not about what u can't do but about what u CAN do!

Great advice doublevision1!

Take care,
Misty

[Ojibajo]

Ojibajo isn't my real name, it is AMY, but your comment made me feel as though I wasn't a real person reading the responses, as I was referred to as OP=Original Poster.

Thank you for the helpful tips. Giving up soda is one of my main goals this year.

[cjldb]

Hi Amy,

I've always struggled with keeping my weight down, even before MS. However, I find that now I am actually eating healthier and losing weight easier that before. I am following the dietary guidelines of Dr. Swank and Professor Jelinek  and doing yoga to help control my MS. It's basically a vegan plus seafood diet. It is not necessarily easy but here's where I find my motivation. I look at my husband and children and know without a doubt that I do not want them to have to care for me in the prime of their lives because I am no longer mobile. That motivates me more than anything else. Any diet I've ever tried has been because I wanted to look better or fit in smaller jeans. This however, is a completely different and much more important motivation. So maybe when you find yourself lacking motivation you can look at those you love and who love you and try to do it for them. I hope this helps.

[supermum_ms]

Ok for those that will forever more hate me, i promise its genetic and i really and truely had no say in it at all, so please love me still lol

I'm one of the little skinny people, i could eat a house with whipped cream on top and i'd still not put any weight on, to me its a curse because i struggle to keep the weight i have. We thought our youngest had my metabolism but it turned out the medication he was taking for anxiety was the cause of his lack of growth and weight gain. Since he stopped taking tofranil he's become chubby, probably due to eating and eating and never having to worry about it, but now he does.

My brother was just like me but he started taking meds for the nerve damage in his feet and in just over a year he now looks like santa. I cant remember the name of it but its one commonly rx to MSers, anyway my point is to look at any medications you take because there could be weight related side effects and thats going to make a big difference in what you can do to reduce any unwanted gains.

My hubby has lost nearly 2 of me and thats been a battle and a half, portian control, healthy snacks and a work out program from hell is what he's been doing, no way would i recommend it, i ache just watching him. lol

Cheers and hugs.........JJ

[doublevision1]

JJ, good reminder to review medications....you're correct that they might be wholly or partly responsible for weight gain/sluggish metabolism.  Lyrica gave me a crazy appetite and I had to stop taking it.  Gabapentin is less effective for me but more tolerable because it doesn't induce hunger.


Amy, I'm glad you've found the above responses helpful and that you're receptive to all of this advice.   I'm sure you understand that these suggestions of ways to improve/preserve your health through diet and exercise, are in no way meant to assign blame to you.  And to blame MS is pointless and self-defeating.  It is what it is.  The symptoms of MS may be what has caused us to slow down, become more sedentary, start to put on weight, etc.  This means that we may have to work harder, with more discomfort, and most likely not be able to do all we used to be able to do, to achieve results that come more easily to the non-afflicted.  

However like you, I want to be proactive and do what I can while I can do it, and find ways to overcome some of the obstacles MS puts in my way, rather than just blame the disease and adopt a mindset of a lack of control and learned helplessness.

I'm glad you posted on this topic as it's one I think we need to revisit now and then.  For many of us it's been a good nudge towards doing the things we know we need to do to keep moving, lose weight, and do all that's in our power to stay as healthy as possible.  We all have different limitations and have to work within them but also push the limits now and then (within reason of course) so that we actually know what our personal limits are.  For me, it can be just a little too easy to blame MS and do nothing, when I'm capable of more.

[doublevision1]

here's a thread from a few years ago that you might find useful:

http://www.medhelp.org/posts/Multiple-Sclerosis/the-exercise-vs-energy-conservation-dilemma/show/544173

[sg400]

A change in eating can boost weightloss by increasing your metabolism - but it takes time. I did this about 10 years ago and have kept the weight off. The entire 'lifestyle change' took me almost a year - but it's lasted.

I first changed my breakfast - started eating whole wheat toast with peanut butter on it. I did not change change anything else until that became a habit (took a few weeks). Then I made the next change - I took the calories that I needed for a day and divided them into 5 smaller meals (breakfast being the biggest). Eventually working in a healthier second meal, and then a third - and I never cut out what I love to eat, I just ate smaller portions. I would tell myself that I could eat two cookies today and then have two more tomorrow if I want. (And pay attention to how you feel after eating certain things - bad and good).

Slow and steady changes will last. A total diet and exercise change made too fast is just too hard to maintain for most people.

I was told a woman should eat 13 to 15 calories per pound of desired weight (based on activity level - 13 if not active). For example 14 x 145 = 2,030 calories per day.... divided into small meals so you eat every three hours or so.

At 1,200 calories per day, MOST women's bodies will slow the metabolism to store as much as possible. 1,200 calories per day is not enough to power the average woman - you are starving yourself.

It will take some time, but amazing things will happen to your body. Your body will stop storing the calories as fat as it learns that you will feed it every two to three hours, and it will enthusiastically burn what you do feed it - that's when you're energy will begin to increase and you can start short periods of exercise - even if it's only 10 minutes per day. If that's all you ever do - then GOOD FOR YOU - be proud of that 10 minutes. And if you have to bail out and nap afterward - go right ahead, it won't take away the work you did.

By the way - 10 minutes of light weightlifting three times per week can strengthen bones and fight osteoporosis. A ten minute walk twice per day can be as effective as one twenty minute walk.

Sorry this was so long - Good luck to you. I know this won't help your MS related issues - but it could help with the standard 'hard to lose weight' issues.

D

[lovemy6monkeys]

I had to start off pretty small and build up. I started using the Leslie Sansone Walk Away the Pounds DVDs. Once I was comfortable doing that I moved on to tougher DVDs. I really like the Biggest Loser ones because they always have a few different levels for each workout.

My goal this Spring is to do the couch to 5K program. I always make sure that I push myself enough to get a good workout, but not so far that I exhaust myself and end up feeling horrible for a few days.

Good luck!
~Jess

[debgen]

Hi Amy,
Like you, I suffer from extreme fatigue and need to tale daily naps. My biggest  MS problems are spasticity in my left leg, which limits my mobility. I make sure that I exercise every day. On good days, I can work out for  30 minutes but other days I need to break it up and do a little at a time. I ride my recumbent stationary bike daily. This is grat for cardio, leg strengthening and burning calories! I also have a routine from my physical therapist that involves stretches, muscle strenghing and balancing. Again, I try to do them all daily, taking breaks as needed. I like working out at home because I can set my own pace. I hope you find  what works for you!
Good luck,
Deb :)
:) Deb

[sllowe]

I'm glad you asked this question! It's so helpful to get tips from others. Afterall, these docs may know what to say for us to do - but doing it is a whole nother animal. I bet if they had the limitations we do they would have some different things to say.
What would we have w/out sharing tips on so many topics - it's why most of us are here.

I have to admit I have not found the perfect combo. I overdue it, and feel so satisfied of what I've accomplished, that I'm willing to take the aftermath. I do too little, and feel weak and tired....sometimes I just go easy, and still feel weak and tired. So, no happy medium for me. But, I'm excited to try something new, and all provided so many good tips I'm certainly going to do some of these!

Thanks, Oji for such a great post and all who provided such great suggestions!
-shell