After a long day at the hospital where she delivered a baby by caesarean section on a 4 ft 8” obese woman, did a hysterectomy, some laparoscopic procedures, and consultations for menopause trauma, incisional hernia, breast cancer and the like, Dr Sheela Nambiar completed her habitual 30-minute run on the treadmill at home. As she crawled into bed around 11 p.m., after setting the alarm at 5 for the next morning’s bike ride, this fitness enthusiast thought about the women she had seen at the hospital. Their lives would be so different, “more productive and less filled with physical and emotional pain”, if they exercised regularly, she says in her book Get Size Wise (Rupa).

She initially tried counselling her patients against prescribed medicines for problems such as obesity, back or knee pain, depression, indigestion, constipation, hypertension and high cholesterol, and suggested they should exercise. But when this failed, she decided to train as a fitness and lifestyle consultant.

Since 2000, she has been practising as both gynaecologist and fitness instructor, and runs a gym in Chennai too. Being a fitness instructor is more difficult; you can’t just write a prescription and walk away… “you are asking the woman to do some very demanding things of her body. Instead of giving her a list of pills to make her feel better, you are making her uncomfortable, breathless, flushed in the face,” she writes.

Weight obsession

Regular exercise, along with a sensible diet, is the mantra of this book. Sheela says the long-term consequences of rapid weight loss through crash diets are disastrous, because the result is the loss of not only crucial muscle mass but also hair, nails, healthy skin and “your sunny personality”! Weighing scales have gained needless significance; “the weig ht you see there is a combination of water, fat, muscle, bone, organ, brain weight. So when you lose weight you have to ensure it is fat weight and not muscle bone and certainly not brain weight”.

This fitness expert advises women against obsession with weight. It is the distribution of weight and the ratio of fat to muscle tissue that is crucial. Without this consideration, lean but muscular individuals can be assumed fatter than they really are, and those who fit the given weight chart but have a high fat percentage live under the illusion they are doing great, she says.

Every woman requires a different impetus to begin exercise. For some it is plain vanity, like looking great in a pair of jeans! For others it may be a health call, another may look at it as prevention of disease.

Fitness is more than losing weight. Of course, regular exercise improves your physical appearance, gives you a “slimmer, more toned, sleek silhouette. Clothes fit better, and you walk tall and with improved posture… which is a combination of proper muscle strength, balance, alignment, body awareness and an inner confidence.” But it also improves energy levels, makes you stronger, reduces stress, and boosts both mood and self-confidence.

But the bad news, ladies, is that men and women respond differently to exercise and food. Men have a higher muscle mass and hence metabolic rate. “They tend to lose fat faster if they make even small changes in their diet and exercise just a little harder. Women usually find it harder to lose fat. This can be disastrous, as when a couple resolves to lose weight together; the man invariably loses faster.”

But the good news for overweight women is that you can be fat but fit, and “from a health perspective that is more important.” These women exercise 5-6 times a week, can run a 12-minute mile, are flexible enough for challenging yoga poses. They lift weights regularly, and are strong and energetic. It has been proved that the positive effects of working out can counterbalance the negative effects of obesity.

But a good night’s sleep - about seven hours - is necessary. Muscle recovery after strength training takes place during rest or sleep. Also, studies have found that women sleeping five or less hours tend to gain weight.

Picture by Bijoy Ghosh

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