I get a lot of emails from people all over the world who are battling some type of joint pain.

And many of these folks find conventional exercise difficult because the load or force used in the exercise is more than what their joint(s) can withstand.

How do you ever get out of this cycle?

Well, here’s an example.

I received this email recently from a reader (I’ve changed the name, city and any other personal information for privacy reasons):

“I’m winding up some work with a local PT for knee problems from osteoarthritis. I bought your knee runners book last summer and was having good luck with it until I tore my meniscus –  just turned my knee too quickly walking around.

I’m hoping to get back into my Total Gym program and add a whole body Fusion routine to help me lose weight. I need to lose at least 65 pounds. Currently my left knee is the problem as that is the one I hurt last fall. I take Glucosamine, Chondroitin and MSM along with fish oil and a multivitamin. I’m also changing my diet to eliminate excessive suger (mostly from soda). My doctor has told me my OA is moderate (medial only, just starting bone on bone contact.”

Thanks,  Jim

If Jim could lose just 10lbs of excess fat, his knee would instantly tolerate up to 30lbs more load. Yep, for every pound you lose, your joint improves its tolerance to load by three pounds.

Jim’s problem – wanting to lose weight but can’t exercise due to joint pain – is common. In fact, the majority of my physical therapy clients were either frustrated because they had the same problem as Jim or they had gained weight since being injured.

So, what do you do? How do you lose weight without exercise?

It’s The Calories, Stupid!

Calories in and calories out. According to some experts, that’s all that matters. It’s a numbers game. Get the numbers right, you lose weight. Get them wrong, you gain weight.

Here’s how it goes:

• Find your “ideal weight”. In Jim’s case, let’s say it’s 165 lbs.
• Multiply your ideal weight by 10 to get your maximum calorie intake per day target. For Jim, that’s 165 x 10 = 1650 calories.
• Track EVERYTHING you eat or drink, record the calories and keep your total calorie intake below the maximum target.
• Get ready to be miserable for an extended period of time.

How much weight you lose and how fast depends on how much difference there is between your usual intake of food and your new target maximum.

As an example, let’s assume Jim has been consistently eating around 2500 calories per day.

If Jim is now taking in 1650 calories, then he has an 850 calorie per day deficit. After seven days of this, he will have total deficit of 850 x 7 = 5950 calories.

Lets round that up to 6000 for slightly easier math.

One pound of fat holds 3500 calories of energy. By creating a 6000 calorie deficit, Jim’s body will “burn” fat to make up the difference. Jim should lose about 1.7 lbs per week with this approach.

Now add in exercise, and let’s estimate a conservative amount of 200 calories of some type of activity per day.

Jim’s total weekly caloric deficit is ~ 6000 (from not eating as much) plus 1400 from exercise for a total of 7400 calories.

Instead of 1.7 lbs per week, Jim should lose just over 2 lbs per week.

Why not just suggest this to Jim? Just keep it simple. Count calories in, subtract calories out and bingo, weight loss.

Because this is why:

• Calorie counting is a challenging if not miserable lifestyle for most people. Imagine, for the rest of your life, counting everything you eat or drink. I’m all for data tracking but having to measure and track all foods forever is an overwhelming thought. Even Weight Watchers has come to the conclusion that counting calories is a mistake (and for what it’s worth, like most things I talk about or suggest on this site, I’ve done the whole calorie counting thing too).

“We needed a program that recognized that calories are most definitely not created equal.

We knew that counting, budgeting and planning still made fundamental sense, but we wanted a better and more accurate currency. We wanted a POINTS formula that was much more “opinionated” about food choices beyond just calories.” – David Kirchhoff, President and CEO of Weight Watchers International

• Calorie counting assumes that the type of food you eat is less important than the quantity of food. This can lead to food “hoarding” – purposely not eating for a period of time to permit a binging on sweets or other more desirable or “comfort” foods. Not a great lifestyle choice.

I’m not saying that calories are irrelevant. And I’m not saying you should never count calories. Sometimes, knowing the calories can provide guidance on the quantity of food but my advice is, if you’re going to count calories, clean up your diet first (more on that below).

If you eat too much of anything, you can gain weight. But in order to develop a lifestyle, a way of living that is sustainable, counting calories fails almost every time.

Is Rush Limbaugh Right?

Although, maybe you agree with Rush Limbaugh  – all that matters is the calorie.

Limbaugh reported on a study conducted by a Mark Haub, a professor of nutrition at Kansas State University.

Professor Haub was overweight and decided to use himself to prove a point: all that matters in weight loss is calories.

So, he placed himself on a diet of Twinkies with some Ho-Hos, Doritos, sugar loaded cereals, and Oreos. He ate these “foods” at three hour intervals.

After ten weeks of this “diet”, Professor Haub had lost 27 lbs, lowered his “bad” cholesterol, and raised his “good” cholesterol.

Mr. Limbaugh says this about the study and his interpretation of it:

“I love being right. Folks, it’s a thrill. I have to tell you, you don’t know what it’s like to be right as often as I am, particularly when you’re simply following instincts, when being right really doesn’t have that much to do with formal education, just being street-wise smart, just having common sense, having the guts to say what you know to be true…”

Well, you’re not right this time Rush.

What the sample-size-of-one study didn’t talk about is the effect of food on your body over time.

The human body is amazingly resilient. We can introduce a variety of “toxins” – cigarettes, sugar, hydrogenated oils, among other things – and live a long time with no obvious negative effects.

You don’t get lung cancer in two months. You don’t get Type II Diabetes in two months. You don’t get high cholesterol and high blood pressure in two months. And you don’t become obese in two months (maybe overweight but not obese).

It takes years to develop these diseases which is part of the problem. There’s not much in the immediate future to cause you to reassess your choices and many people struggle with delayed gratification which is what living a healthy lifestyle includes.

The Secret? It’s Just One Thing

There’s one thing. One thing, if you get it right, will help you balance your body fat without much or any exercise.

More important than the quantity of food, is the type of food.

That’s the one thing.

For example, the Pima tribe of Arizona had virtually no incidence of obesity, diabetes or other “lifestyle” diseases until their diet changed from indigenous food sources to the food supplied by the US government – white flour, sugar, processed cereals / foods – and the more “modern” lifestyle of sedentarians along with fast, more convenient foods.

Here’s a group of people who had an apparently well balanced blend of food and activity that fit their genetic heritage and as a result were quite healthy for a long time.

Then, they changed both variables. They became less active and ate a more “modern” diet. And over several years, they developed lifestyle associated diseases.

And the same thing is happening to Asian nations.

The Steps to Losing Weight When You Can’t Exercise

Step 1 – A Food Journal. You need to keep track of everything, I mean everything, you eat or drink for seven days without changing from what you would normally eat or drink. At the end of the seven days, you’ll have a reasonably good snapshot of your diet.

Step 2 – Examine the food journal. Look for patterns. Do you skip breakfast? Do you eat similar things for lunch and what sort of food is it? What about snacks or sodas? How about alcohol? What do you have for dinner? How often do you dine out? What you want is consistency. yes, it can be boring to reduce your meal choice but you have to keep your eye on the goal. Once you make your eating choices more mindful, then you can introduce more variety. But, in the beginning, boring wins.

Step 3 – Think baby steps. Change lasts when the changes are small and become incorporated into your lifestyle. You don’t have to change everything in your diet all at once. Pick one meal and change it.  Just start with one thing and build on that.

Step 4 – Baby step: Eliminate any added sugar. Before you completely re-work your diet, start with tossing the sweets, sodas, cookies, and ANY food that has sugar added to it. Read the label. You might be surprised at how many foods have added sugar. Fruits are okay – you have to eat a LOT of fruit a LOT of the time for it to be truly bad for you. I doubt you can eat that much fruit. For example, if you drink three 20 ounce Cokes a day, you would have to eat 9 really large apples to get the same amount of sugar (and I’m not even talking about the kind of sugar – that’s another day).

Step 5 – Baby step: Don’t eat anything out of a package or a box. Choose from the following types of foods to assemble your meal plan:

• meat, fowl, fish, eggs, vegetables, fruits, nuts, seeds, healthy oils. Limit grains to quinoa and whole grains for now (you may be able to expand that option later – it depends on how your body handles the carbohydrate). Cheese is okay as long as it’s real cheese and not, for example, Velveeta.

Step 6 – Keep Portions the size of your fist. If you keep your food portions to roughly the size of a closed hand – fist – you’ll be close in terms of quantity of food. It beats weighing, measuring, and counting all the time.

Step 6. Be real. A lot of people feel that they have to be all or nothing when it comes to a change especially diet. Big mistake. Adopt a more realistic perspective. If you can change at least 50% of what you’re currently eating to something that is more “whole”, you’ll help yourself a lot. If you can hit 80% (and that’s my personal plan), you’ll be in much better health, have more optimal levels of fat, and feel a lot better.

If you do the above steps, you’ll naturally lose excess fat until your body reaches an equilibrium. And very likely, at that point, you’ll be within healthy ranges of body fat.

And you haven’t even added exercise.

And you will have bumped your joint load tolerance significantly.

Why Exercise Is Not The Sole Answer To Losing Weight

Some of my clients have told me that they exercise so they can eat whatever they want.

And, this works, sort of, until you can’t exercise at the intensity or duration you need to.

Then the wheels come off the wagon. The wagon goes off the cliff. Life feels like one long series of disasters.

You gain weight. You’re frustrated because you gained weight so you eat (or drink) to reduce the stress created by the weight gain.

But eating and drinking leads to more weight which leads to more stress which leads to more eating and drinking.

Then you get bitchy. Irritable.

Am I close?

This is why I strongly suggest you NOT count calories or use exercise to “balance” the calorie scale.

Purposeful exercise is best used to “harden” your body; to make you more resilient, more capable and not to create a caloric furnace.

The first step is to overhaul your diet and as you lose weight you get a fringe benefit: for every pound of fat lost you gain three pounds of increased force capacity in your joints.

So, your joints get stronger without exercise.

Why not get started today on your baby steps?

photo credit: Arya Ziai via photopin cc