by Christina
Medvescek
If you’re reading this article, you’ve probably
already tried to lose weight. You already know the basic, simple
formula for success (burn more calories than you eat), and you
know just how devilishly hard it is to follow.
People with neuromuscular diseases are up against a double (or
triple or quadruple) whammy when it comes to losing weight. In
addition to the usual dieting challenges — yummy fattening
food everywhere — they must contend with the impact of muscle
loss, decreased physical ability, and wheelchair or steroid use.
And, although all the data aren’t in, researchers suspect
those extra pounds may be even more unhealthy for people with
progressive muscle diseases than for others.
Medical experts and dieters agree on one thing: By better understanding
how your neuromuscular disease (NMD) and your weight interact,
you can find a weight management strategy you can stick to for
life.
A Big Problem
In general, our research has documented that persons with NMD
are more sedentary, exercise less and have higher adiposity [more
fat] than persons without NMD,” says Susan Aitkens, a researcher
in the Rehabilitation Research and Training Center in Neuromuscular
Diseases at the University of California at Davis.
UC Davis is investigating whether people with slowly progressive
NMDs (such as limb-girdle or myotonic muscular dystrophy) are
at a greater risk of developing metabolic syndrome, a weight-related
condition strongly linked to the development of heart disease
and type 2 diabetes. Although still in the early stages, the study
suggests that people with NMDs have a higher incidence of metabolic
syndrome (sometimes called syndrome X) than their unaffected
peers.
Besides potentially increasing your risk
of getting another chronic disease, extra weight makes it harder
to cope with the effects of NMD. Being overweight impairs mobility;
adaptive equipment may not fit or work as well; caregivers have
to work harder. Some people find they can’t think as clearly
when they carry extra weight.
The bottom line: Even though as many as two-thirds of Americans
are overweight, “Obesity may be an even bigger problem for
the NMD population,” says Greg Carter, MDA clinic director
in Seattle, Tacoma and Olympia, Wash. As hard as it is, it’s
important not to give up and allow the weight to pile on.
Muscles Matter
Most calorie burning occurs in the muscles. Therefore, the less
muscle mass you have, the lower your resting metabolism and the
fewer calories you burn just sitting around. This isn’t
great news for someone with a muscle disease.
Experts agree that exercise — no matter how limited —
is a valuable part of an NMD weight loss plan. UC Davis studies
have found that moderate exercise — walking, lifting weights,
using a resistance band — yields positive results for people
with slowly progressing muscle diseases. Heavy exercise doesn’t
provide more benefit than moderate, and it might be detrimental.
(See “Making Muscle, Burning Calories”
for guidelines.)
“The key is to be more active than you are currently,”
emphasizes Megan McCrory, a nutritionist and researcher at the
Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts
University in Boston. “Add a few minutes of walking (or
other exercise) every day or every other day. Make it a priority.”
Small Victories Count
Another part of the solution is to set a reasonable weight loss
goal. Rather than shooting for an ideal weight, look for ways
to reach and hold a healthier weight.
Research shows that a modest loss of 5 percent to 10 percent
of your starting weight, sustained over time, can lower blood
pressure, reduce cholesterol and dramatically cut the risk of
type 2 diabetes. If your weight isn’t yet a big problem,
simply holding steady also counts as a victory.
Above all, don’t embark on a rapid-loss diet strategy.
Slow loss is likely to be more beneficial for people with muscle
disease, says Ted Abresch, director of research at the Center
in Neuromuscular Diseases at UC Davis. Diets in which “the
pounds melt away” usually result in rapid regaining down
the line, often to a weight that’s higher than it was before
the diet. (See “Taming the Hunger
Monster.”)
MDA doesn’t endorse or recommend any of the weight-loss
strategies mentioned in these stories. Always consult your
doctor and other NMD experts about the best diet or exercise
program for your individual situation.
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A Moment on the Lips
Some doctors have gone so far as to call obesity a “chronic
condition” because it’s so hard for dieters to keep
from regaining lost pounds.
But people with NMDs already know how to deal with chronic conditions.
Just as with a neuromuscular disease, a weight problem may not
be “curable,” but it can be “managed.”
The keys are: Find the diet and exercise program that best suits
your body and lifestyle; go slowly and know you’re in it
for the long haul; and don’t feel guilty or stressed about
things you can’t change.
You still may not look like a fashion model, but you’ll
have improved health and a real sense of personal power to show
for your efforts.
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