Based on past research, the top reasons why people drop out of exercise programs are the following (in no particular order): 1) lack of time, 2) exercise intensity too high, 3) orthopedic injury, and 4) lack of enjoyment. I will address each of these reasons individually and give you some ideas to help your patients avoid or overcome each one.
Perceived lack of time: No time to exercise today (or any other day)? Schedule your workout into your day just like you do for other important appointments and meetings. If that doesn’t work for you, focus on doing more daily physical activity of any type. Don’t worry so much about making it to the gym or give up entirely on working out if your planned time is demoted to a lower priority on any given day. Just do as much as you can all day long by taking more steps and even standing up longer. If you’re just starting out, begin with 5-10 minutes a day and add a little more each day, working up to doing at least 10 minutes at a time, three times a day. You can also try for 15-minute bouts twice a day. It even helps to make physical activity part of your daily routine. For example, walk or bike to work or to the store, exercise while you watch TV, take the stairs instead of the elevator, or do something active with your family instead of being sedentary together.
Exercise intensity too high: Have you seen individuals working out with personal trainers at your gym? What they’re doing frequently is not only downright intimidating (a five-minute plank?), but also fails to look like much fun — and you’ll almost never see those same individuals pushing themselves as hard as that when they’re working out on their own. It’s not that working hard is necessarily bad, but trying to exercise that intensely when you’re just starting out is a bad idea and a major reason why people drop out of exercise programs. Not only is it not enjoyable to be pushed too hard when you’re beginning your program (making your exercise a "punishment" of sorts and demotivating), it also often leads to more severe muscle soreness and overuse injuries. "Start low and go slow" is a better practice to follow to make sure that you’re not one of the dropouts. You have to learn how to walk before you can run (so to speak).
Orthopedic injuries: People with diabetes already have higher rates of overuse and other orthopedic injuries, particularly if they’re carrying around a lot of extra body weight. Hip and knee arthritis are common in overweight people, and having diabetes increases the risk of joint irritation and injuries long-term. Exercising safely and wearing appropriate shoes can help lower your risk of acutely injuring yourself while working out and prevent you from developing overuse injuries like tendinitis. Elevations in blood glucose levels over time increase the glycation of collagen structures around the body (including tendons, ligaments, and joint surfaces). While mild to moderate exercise usually improves arthritic knee pain, exercising too intensely without working up to it slowly can result in inflamed joints causing people to stop exercising. You can also use the "start low and go slow" philosophy to prevent injuries that limit the ability to exercise. It’s not a race to the finish, but rather a lifelong journey that you need to take at an appropriate speed to make sure you can make it to the finish line in one (healthy) piece.
Lack of enjoyment: A large part of staying motivated to do anything comes from enjoying what you’re doing. If your exercise routine is boring, find something else to do that you enjoy more that makes it fun or "adult play." Mix it up and try different activities on different days, or try something new. Exercising with a partner to keep you company can also be very motivating. Another idea is to catch up on your reading, listen to music, or watch your favorite TV show while you’re working out. Anything that helps the time pass and allows you to enjoy what you’re doing is a good thing to try.
Whatever you do, don’t let yourself become one of the dropout statistics. Exercising is too important to your health for you to consider it anything less than a non-optional, non-negotiable part of your daily life.
Dr. Sheri Colberg is the co-author of The Diabetes Breakthrough: A Scientifically-Proven Program to Lose Weight, Cut Medications, and Reverse Diabetes in 12 Weeks, which is scheduled to be released in November 2013. Her co-author is Dr. Osama Hamdy, the medical director of the Joslin Diabetes Center’s obesity clinical program and faculty at Harvard Medical School, who created their Why WAIT program, the world’s first clinical practice program designed to help patients with diabetes lose weight through a novel multidisciplinary approach.
Copyright © 2013 Diabetes In Control, Inc.