Exercise for the Seriously Unfit

You've been out of shape before, but this time it's serious. You can't walk across a room without huffing and puffing. Your arms get tired unpacking a bag of groceries. You're carrying more and more excess body weight. And you can't remember the last time you got any real exercise.

If you see yourself in this picture, you have cause for concern. You may be simply unfit or you may have underlying medical conditions that rob you of stamina. Before approaching a workout program, see your health care provider. If it turns out that you are simply unfit, it’s time to begin your fitness program. Being unfit robs you of quality and enjoyment of life. A sedentary lifestyle also puts you at risk for serious diseases and early death.

Benefits of exercise

The reverse is also true. Regular exercise can greatly improve your quality of life, reducing risk factors and reversing the progress of some diseases.

"You can reap significant benefits, even if your couch-potato lifestyle has already begun to take a toll," says Wayne Miller, Ph.D., an exercise science specialist in Washington, D.C. "The challenge is to develop the attitudes and skills to make exercise a continuing part of your life."

That takes commitment and organization, even for those who are in relatively good shape or moderately active. If you're seriously unfit, the job will probably be harder.

For example:

You'll need to break free from months or years of sedentary habits and start seeing yourself as an active person, maybe for the first time.
You may also have underlying health issues associated with long-term inactivity, such as extra weight, high blood pressure, circulation problems, or diabetes. Before you begin any fitness activity, check with your health care provider to determine if you have any health conditions that exercise could affect. "If you do have an underlying health condition, it's important to get it under control," says Dr. Miller. If you have diabetes, for instance, learn how to monitor your blood glucose levels and make any necessary dietary adjustments before and after activities. If you have hypertension, make sure your blood pressure responds normally to exercise.
And, of course, if you haven't climbed a hill in a while, you'll probably have to go slow at first and take some breaks along the way.

"Just do what you can," urges Kathie Davis, executive director of San Diego-based IDEA, the Health and Fitness Association of Fitness Professionals. "When you're just beginning, any activity is better than nothing. What's important is choosing activities you enjoy and staying with them."

Get set for success

"To increase your chances of long-term success and to decrease risks, be well-informed before you start your exercise program," says Dr. Miller. "Be realistic about what you want to accomplish and make a serious commitment to do it."

Here are some strategies:

Set goals. Consider what health benefits you'd like to achieve: lower blood pressure, increased cardiovascular fitness, healthier body composition (more muscle, less fat). Decide with your doctor the best way to chart your progress.
Be realistic. Get smart about what exercise can do for you—and how fast. In general, for every year you've been sedentary, it takes one or two months of exercise to make up for what you lost in fitness.
If possible, start off with a professional. At least in the beginning, it's important to work with a trainer or physical therapist who's aware of your condition and who can help you design a safe, effective program. If you have underlying health issues, they should help you monitor the effects of exercise and make any necessary adjustments.
Put fitness front and center. Any program that depends on you getting up early or shaving time from other activities is unlikely to last. Instead, find something you're willing to give up—such as watching that nightly game show; or get home exercise equipment and exercise while you watch the nightly game show.

"Think of exercise as any other long-term relationship. It needs and deserves real quality time," says Dr. Miller. "You want to fit exercise into your life, not squeeze it in."