"Preparing for Orthopedic Surgery: Fitness Considerations“ Becky Henry, Hope Network, LLC

The Weight Issue

Becoming Fit/ What is Fitness? Fitness is the ability to meet the demands of a physical task - including endurance, flexiblity, balance and strength

Excessive weight adds to stress on bones and joints, and poor fitness and sedentary life-style make recovery more challenging.

Preparing for surgery; Fitness & conditioning make recovery from surgery easier.

Focusing on weight loss – what is result?

Weighing considerations - some patients do not want to be weighed - when this is necessary for anesthesia purposes it can be done privately & without showing/telling the patient their weight which can be very shaming and can do harm.

Considerations in the 4 populations : Pre-Op, Post Op, Transitional Care and Home Care

Watching for disordered eating red flags in post-op patient

Dietary discussions and watching language to focus on gaining health not losing weight

Some basics of coach-like language to encourage patient to find the motivation within to gain health rather than being told what to do.

Most patients are not willing to make needed dietary changes - and telling them to reduce their intake of soda for instance is not going to create behavorial change. Rather it will create shame and resistance.

Focus on gaining health not on losing weight (language) Encourage

Use of goals to get moving and keep moving and GAIN fitness and health in all patients.

Adopt healthy lifestyle habits. Develop and nurture connections with others and look for purpose and meaning in your life. Fulfilling your social, emotional and spiritual needs restores food to its rightful place as a source of nourishment and pleasure.

Find the joy in moving your body and becoming more physically vital in your everyday life. Eat when you’re hungry, stop when you’re full, and seek out pleasurable and satisfying foods. Tailor your tastes so that you enjoy more nutritious foods, staying mindful that there is plenty of room for less nutritious choices in the context of an overall healthy diet and lifestyle.

Resources: Bacon, L. Evaluating a "Non-diet" Wellness Intervention for Improvement of Metabolic Fitness, Psychological WellBeing and Eating and Activity Behaviors. International Journal of Obesity The weight of Americans continues to increase, particularly among dieters. ~ Flegal, K., et al., Prevalence and trends in obesity among US adults, Journal. American Medical Association, : p And eating disorders and weight preoccupation are painful side effects.~ Polivy, J. and C.P. Herman, Dieting and bingeing: A causal analysis. American Psychologist, : p The vast majority of people who try to lose weight regain it, regardless of whether they maintain their diet or exercise program. ~ Miller, W.C., How effective are traditional dietary and exercise interventions for weight loss? Medicine and Science in Sports and Exercise, (8): p

Assumption: The only way for “overweight” people to improve health is to lose weight. Most health indicators, such as insulin sensitivity and cholesterol levels, can be improved through changing health behaviors, regardless of whether weight changes21, 22. Even people who gained body fat while participating in an exercise program have improved their health23, Bacon, L., et al., Size acceptance and intuitive eating improve health for obese, female chronic dieters. Journal of American Dietetic Association, : p Gaesser, G., Is it necessary to be thin to be healthy? Harvard Health Policy Review, (2): p Lamarche, B., et al., Is body fat loss a determinant factor in the improvement of carbohydrate and lipid metabolism following aerobic exercise training in obese women? Metabolism, : p Bjorntorp, P., et al., The effect of physical training on insulin production in obesity. Metabolism, : p Hope Network, LLC – Becky Henry –

CONFLICT OF INTEREST I hereby certify that, to the best of my knowledge, no aspect of my current personal or professional situation might reasonably be expected to affect significantly my views on the subject on which I am presenting.