The Exercise Transformation

I usually write about an item in this week's news or in the recent medical literature.  Forgive me from straying from that path this week to share some personal reflections. For sedentary patients there is an enormous psychological barrier to exercise.  All primary care doctors face that barrier daily.  We encourage, cajole, practically shove our patients to become more physically active.  The vast majority of the time, despite the patient's and the doctor's best intentions, no change occurs.  ...
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Osteoporosis Screening: Not Just for Women Anymore

Osteoporosis, which means very low bone density, is a major risk factor for fractures.  Fractures can be catastrophic for older people, and effective medicines exist to treat osteoporosis and prevent fractures, so detecting osteoporosis before a fracture happens is very important in older patients.  Since osteoporosis is very common in postmenopausal women, screening them for osteoporosis is a well-established part of preventive care. Though men are less likely then women to have osteoporosis, ...
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Even a Little Exercise is Better Than None

I am constantly encouraging patients to exercise.  Usually, the motivation is physical health -- the patient's weight, or blood pressure, or cholesterol, or sugar is too high and exercise is the healthiest way to normalize it.  But I'm increasingly impressed by the ability of exercise to improve mental health.  Patients tell me all the time that their mood is better, their anxiety lower, and their thinking sharper when they exercise than when they don't. A recent study adds evidence to that bel...
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Laparoscopic Gastric Banding Can Cure Diabetes in Obese Patients

The scientific evidence for treatment of obesity is trending in a very interesting direction.  For years a safe and effective medication for weight loss has been sought, with only modest results.  (I wrote about orlistat, the medication in Xenical and Alli, a year ago.)  Surprisingly, for obese patients evidence is increasingly mounting in favor of surgery for weight loss, rather than medications or even diet and exercise. In 2006 ...
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Shocking Study: Pedometers Motivate People to Walk More

Last week's post generated many comments from you, and I appreciated them very much. With Thanksgiving approaching and New Year's resolutions around the corner many of us are reviewing our commitment to our exercise program (or realizing that for the last few months we've had no commitment and therefore no exercise program).  With this perfect timing, this issue of the Journal of the American Medical Association published a More

Shocking News: Diabetics Should Exercise

This week's Annals of Internal Medicine has a very well designed study that examined the effect of exercise on patients with diabetes.  Previously sedentary diabetics were randomized to four groups:  one group was enrolled in an aerobic exercise program, a second group was enrolled in a resistance training program, a third group was enrolled in a program with both aerobic exercise and resistance training, and...
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Studies You Should Ignore

The media constantly bombards us with studies purporting to show new evidence about medicines we should avoid, or foods we should eat, or behaviors that either protect us or harm us. Many of these studies, because of their design, actually tell us absolutely nothing. Nevertheless, the media is not in the business of downplaying the news, so the studies are inevitably announced in the mainstream press with much fanfare and little scientific scrutiny. So that leaves us, the consumers of the news ...
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The Pedometer Project: Steps that Make a Difference

With the end of 2006 a few days away many of us turn our thoughts to the New Year and seize the opportunity to rededicate ourselves to healthier habits. I personally know all too well how easy it is to stop exercising and how hard it is to start again. I also know how insidious inactivity can be. In the last month alone, I've had to tell three of my patients that they were in the earliest stages of developing diabetes. For them, the need to exercise and to pay compulsive attention to their diet ...
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