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Testing Is Advised Before Starting Any Exercise Program

Weight loss is a multibillion-dollar industry. It includes programs--the good, the bad, the ugly -- that worsen a weight problem, promise to change it overnight or, in the rare cases, promote healthy lifelong change. It is especially important now. A federal panel has just concluded that weight loss is as serious a national problem as smoking. In a three-part series, The Times takes a look at the impact of weight loss programs on people in San Diego County--from diet to exercise programs, from snake-oil remedies to the traumas of morbid obesity. Today's segment takes a look at the medical repercussions--psychological and physical--of "the problem that won't go away."

April 08, 1985|MARIBETH MELLIN

SAN DIEGO — You are about to embark on a rigid diet and exercise program. You've bought your sweats and shoes, sworn off chocolate and beer, and are filled with righteous intentions. By summer you'll be struttin' your stuff on the beach with the rest of the beautiful bodies. Such are the things a dieter's dreams are made of.

Too often, those lofty ideals turn to nightmares as the reality of Spartan living sets in. By the end of the first week, you're so weak you can hardly move. Your shins feel like metal plates, and there's a band of steel wrapped around your chest. Your heart has taken to beating wildly each time you tie your Nikes, and your stomach lurches in the presence of cottage cheese. You quickly become convinced that your body belongs on a hospital bed instead of a weight bench, and you expend all the energy you have left just getting to your doctor.

Too bad you didn't start your program there.

It's common knowledge that before you begin a diet or exercise regime you should get your doctor's permission, but many of us ignore that caveat. After all, we feel fine and intend to get even better. Why spend the money on a doctor who's just going to tell us we need to lose weight?

"If you're going to drive across country and have a brand-new car, it's OK, but if that car has 50,000 miles on it, you'll get it checked out. If it has 100,000 miles on it, you'll check it out even more. The same thing goes for your body," said Dr. Steven Van Camp, a cardiologist in private practice and consultant to the American Heart Assn. and San Diego State University's Adult Fitness Program.

"Not many people will go to a doctor if they think nothing's wrong, but most people really don't have 'nothing' wrong with them. You need to detect any medical problems that might be made worse by exercise or make exercise dangerous. The only thing that you can do that's positive in health enhancement (without giving something up) is exercise; it's the major part, the foundation of health. When you start a program, that's the time to see a doctor and identify your problems. Then you have a good chance for total health enhancement. When you're all wound up and ready to go, the last thing you want is a bad experience."

No Rude Surprises

What you do want is to be able to diet and exercise safely and comfortably, without rude surprises such as sudden chest pains or constant hunger pangs. To achieve your goals you need an overall assessment of your body's condition, and an idea of how far you can push it without causing damage, medical experts say. You want a fitness evaluation, something beyond the normal annual physical that lets you know exactly where you stand.

Such checkups are required by some intense diet or fitness programs and are recommended by activity-oriented physicians for any adult partaking in vigorous exercise or planning a major weight loss. Programs like Scripps Clinic's Executive Health Plan, UC San Diego Extension's Fitness Profile and San Diego State University's Adult Fitness Program incorporate the essentials aspects of an overall fitness evaluation as well as other tests that, though not necessarily vital, do give a more thorough picture of your condition. Of all the tests available, the following are considered desirable, depending on your age, current activity level and history:

- The health history. This is the backbone of any evaluation, beginning with a record of your and your family's medical problems, including an assessment of your current life style. A thorough history will point out many of the risk factors that contribute to cardiovascular disease, the No. 1 killer of Americans. Such factors include your age and weight, the incidence of heart problems or diabetes in your immediate family, the number of cigarettes you smoke and amount of alcohol you consume each day, how much you exercise and the stress you're under. These factors, along with others acquired during a physical exam, will determine what other tests you require.

- The physical exam. Besides ruling out symptoms of disease, the exam offers a good picture of your current health, including a record of your blood pressure. Richard Cotton, an exercise physiologist with Scripps Clinic's Preventive Medicine Center, suggests that more than one blood pressure reading be used to determine your rate, since factors such as the anxiety of being in a doctor's office can elevate your pressure.

- Blood tests. Blood samples taken in your doctor's office or a laboratory can indicate the levels of many properties in your blood, including protein, sodium, sugar and cholesterol. The glucose test, which determines sugar levels, is considered essential because it is an indicator of diabetes, which places a tremendous strain on the cardiovascular system. And the cholesterol test is a must, most fitness experts say.

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