Interview with Dr. Botezelli – What are the most recommended exercises before and after Bariatric Surgery?

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Amanda Interviews Dr. Botezelli

Topic: Segment 3:

Bariatrics and Exercises – What are the most recommended exercises before and after Bariatric Surgery?

Amanda: Hello everyone, welcome back to our third segment of today’s interview with Dr. Botezelli on Bariatrics and Exercises. What are the most recommended exercise from your practice that you recommended to Bariatric patients either before they have the surgery or after they had the Bariatric surgery?

Dr. Botezelli: So, I like to compare our muscles to an elastic (when you pull it in the beginning it is pretty easy, then it starts to get harder, that is our body). If you are starting to exercise right now, it’s like a new thing that you want to change your life, so you’re doing the Bariatric surgery and then you decide to do exercise, every kind of exercise that you do, will produce good results in your body, tremendous results. If you talk about an athlete, they train a lot, so the elastics pulled all the way, so it’s super hard to get improvements. But in the beginning, if you are sedentary, if you don’t exercise that much, anything you do will produce really good results and fast results, so we see improvements by 30-40% of strength and endurance in 1-2 months, it is pretty fast, our body would adapt pretty fast. The point here is you need to do both endurance and strength exercise. The strength exercise will help you to keep your muscles, to make the muscles grow, to make the muscles bigger, even though you are in a caloric restriction, you are keeping your muscles. And this is important, because remember, in the two previous topics of this interview, when you do the Bariatric surgery, usually you lose a lot of muscle, so when you build this muscle before and after the surgery, you are increasing your metabolism, you are increasing the capacity of your muscle to generate power and burn calories. The endurance exercise is pretty important because of two things: first, endurance exercise (when I say endurance, I say bicking, elliptical, running, swimming, even walking, you don’t need to start running), it burns a lot of calories and most of the calories from fat, so it will reduce your triglycerides, it will improve your cholesterol in you blood, and also you prepare your body to get more oxygenated, so you produce more red cells, you get better quality of your blood, your blood will carry more oxygen, this is amazing before the surgery and after the surgery to recovery. We need oxygen to activate our metabolism, and help with the regeneration of your body. Both exercises are great
(we need both endurance and strength exercises) they are quit of mandatory before and after the surgery, because this way you keep your muscles and you spend more energy and you will affect your metabolism to prepare you for the surgery and to prepare you for a new routine and new life after the surgery.

Amanda: Great point! Please, clarify to our listeners/viewers with more examples as a lot of people don’t understand the word cardio and the difference between endurance and strength exercises before and after Bariatric surgery.

Dr. Botezelli: Endurance or cardio, is the exercise that you do for a very long time, because you have to sustain this exercise for a very long time, it is a lower intensity, so your body needs to get more efficient and break the energy, the substrates, fat, carbohydrates in a really good efficient way. So, if you need to run 1 kilometer, for example, or walk for 1 kilometer, usually, because it is a lower intensity exercise, your body will need to break down more fat, so this way you will burn more fat. “Ok Diego, if burning fat is a good way and I want to lose fat, should I do endurance exercise all the time?” Not all the time, because endurance exercise will make your body more efficient, you won’t grow muscle, because the amount of muscle that you have, with that muscle, you can walk for like five, 10, 20 kilometers, so your body will not try to grow your muscle. Sometimes during endurance exercise, you actually lose muscle, because your body wants to get more efficient. So, endurance, cardio exercise is good to burn calories, but you also need strength exercise, power exercise, and body weight workout to keep your muscles. So, mixing both of them is the best strategy. Do one day strength exercises, you can do squat with you own body weight, you can do press ups in the wall, you can buy small dumbbells and do curls, you can do many exercises, usually in my App I just sent the entire routine, we have videos, we have all the reps, the exercises, the explanation, it is pretty easy to follow. These strength exercises will keep your muscles, so we have the best of the two words: first, it will keep your muscles, so will keep your metabolism high, and the second will burn more calories, it will reduce the amount of fat that you have.

Amanda: I really appreciate the App you have with the exercises, because a lot of times we forget what that exercise is and instead of you having to go online and look for the exercise, you can watch the short video where the person is showing the exercise to you, it is so practical, easy and you can do in couple of seconds. And another thing that I really appreciate that you do a lot (on your Instagram, social media) home exercise, and this is so important for us to talk to people about. Here is the story: I have clients in the pre-op phase and they tell me “Amanda, I am so not used to doing exercises, I just don’t have the energy right now because I have all this weight on me” and I respond: “I get it, been there, done that, but there are no excuses”. I also have clients in the post-op phase, they have already released a lot of weight, but they still tell me the same thing: “Oh, I still don’t find time to exercise, I am at home” and again I respond: “There are no excuses”. And the reality is: “There are no excuses”, you give me so many strategies and, it is all about changing habits and changing the mindset, and mindfulness eating (which I talk a lot about it in my Bariatric Coaching), the key is to move, I do so much home exercises which I never thought would be possible to do before and I learned so many strategies with you. You have some quick videos where you are working on the computer (like I do all the time) and then you do a little stretching and you do a little bit of exercise, tell us more about it.

Dr. Botezelli: The average North American spends almost six hours per day on the cell phone or screen (checking Instagram, WhatsApp, social media, email, etc). We spend a lot of time on Netflix, so they had to reduce the traffic and the quality of the videos actually in the last like 4 or 5 months, because people were watching it all the time. We have time! This is one point, we have time! And one thing that will help even your work (now I have my schedule pretty tight), I have a timer here and every like 1 hour, you just take a break and do 3-5 minutes of exercise, if you do this every hour of work (so if you work 8 hours per day, you have around 40 minutes of exercise per day, that’s it, that’s amazing, that’s what you need, you need 40-45 minutes of exercise, plus this exercise while you are working, will pump your blood better, will oxygenate your brain better, so you won’t get distracted. Instead of getting your phone and checking your WhatsApp message, your Instagram, just do 3-5 minutes of exercise per day. This is more than you need, you will be more productive too, because you are activating your metabolism, you also activate your muscles. This is like a general complaint: most of my clients have back problems, because (I’m seated right now) because we spend the time on the chair all the time and because our abs are not working, just our back is working, so you will start producing imbalance in your back and we will start to feel pain in your back, lower back specially. If you stand up and warm up your muscles, do a couple of abs, you don’t need to do fancy exercise. You just need to stand up at the side of your desk, do 20 squats, 20 jumping jacks and that’s it! You do this 8 times per day, it’s like 3 minutes doing this, bring a bosu ball to your office, go there and sit in the bosu ball and mix the chair with the bosu ball, because in the bosu you are always imbalanced, so you are working your core all the time. If you are working like six hours per day, you’re working your core like six hours per day to make you stable instead of a super comfortable chair. You can start like 1 hour in the bosu ball and 1 hour in the chair, we can mix this and make things more efficient. You don’t need to go to the gym and this is hard after a stressful day of work, when you get home you need to get into your car, change, go to the gym, it is like 30 minutes to go, 1 hour there, then 30 minutes to get back, it is like 2 hours, so people don’t want to do this, but you can apply these small changes to your life: if you are living in a building, take the stairs (if you live in the 15th floor, even better). “I don’t have the cardio, the physical capacity to go 15 floors” ok, start with one, and then the next day you go two, then three, as I said, your body will adapt crazy crazy fast when you start, I promise you, in less than two weeks, you are going to 15 floors easy.

Amanda: And you start feeling better, it is something that is totally doable and the more you do, the better you get at it. Thank you for all the exercises strategies.

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