Why “FIT” has nothing to do with “FAT”


Fitness is a gift.

I honor strength and people who do the work to enjoy the gift that is fitness.  Regardless of age or size or how their level of adiposity (fat cells)- if they do the work to keep their bodies strong and healthy, at whatever level/size they are able to achieve, they are enjoying the gift of fitness.

I made a post on Facebook yesterday that was taken completely out of context by a good lot of people and I am feeling bad about it, because it was not my intention. Strangely, whenever I mention the word “fitness”, or lack there of, people generally automatically assume I am calling someone fat.  Words can easily be taken out of context.  Perhaps, as a skinny girl, when I talk about fitness it is assumed that I am laying blame or pointing a finger at those less thin? I am not and my intention is to state things objectively, which still offends many. I’m very straight forward, that’s part of it.  I don’t apologize for that. However, I am not implying half the things I get accused of.

My post yesterday was on the topic of how exercise videos state, “Before engaging in this program or any other, please consult your doctor for advice”.  My next impulse is usually to chuckle because, as someone who has been to many a doctor in my lifetime and gone to school with hundreds, maybe 10% of them actually had a clue about real fitness.  The rest either did nothing themselves or were cardio junkies.  As I wrote the post I was thinking about a past doctor who looked like a skinny bird and told everyone to walk more and eat less fat.  That was the vision of “unfit” that I had in my head as I wrote the post.  Unfortunately, most everyone took my post as calling doctors fat.

I am a skinny girl, I always have been. My family is not thin.  So how did I end up thin? As a Naturopathic physician I am keenly aware of gastrointestinal health and it’s impact on one’s body.  What I always had been, until more recently, was a malnourished girl who couldn’t absorb enough nutrients to put/keep weight on in a healthy way.

I’ve been sick as long as I can remember.  Until recently I was always “that girl who got sick”. Let’s just say it’s been a LONG journey to get myself to the level of health and fitness that I now enjoy. Straight uphill battle. I have spent most of my life, aside from just the last decade, either sick (I mean SICK, in an out of doctor’s offices all of the time), or eating horribly or starving myself or all of the above.  I have nearly a handful of autoimmune conditions and have seen my hormones literally bottom out more times than I’d like to count.  Sadly, I did most all of it to myself. The punch line?  You would never guess it by looking at me.

Back to my family.  

There are some good genes in there all right.  Unfortunately many of my family have not figured out the life hacks for our genetic lineage.  Fortunately for me, I’ve dialed some of it in early enough to make a difference.  Unfortunately for me, I took complete crap care of myself for so long that there is some permanent damage done.  I chain smoked for a decade, lived off of bread and cheese and sugar, didn’t exercise much for a good decade and put myself through enough stress to kill an elephant. However, I know there are good genes in there and I try to get them to express themselves as much as possible!   It all comes down to how our genes express and we can control that to some degree.  How cool is that? Our genome is not up to us, but our phenome (or how our body expresses our given genetic code) is very much under our control.

That takes me back to fitness and my background, personally and professionally. Personally, my body responds quickly to exercise, so I adapt well and build muscle nicely.  Thanks Mom and Dad!  I also pack weight around my mid-section just by looking at a starchy carb, not so much thanks Dad.  I get my autoimmune conditions from both sides of the family, and I can tell you that until I figured out what the hell was going on with my immune system, life was pretty crappy.  I recall being sick as long as I can remember being alive.  Literally.  Feeling like crap, for no known reason, itching all over with no visible rash, joints hurting with no visible swelling, brain aching for no good reason…..just feeling like crap.  Sitting in bathtubs of oatmeal and epsom salts as an elementary aged kid crying because I couldn’t make the hurt and itch stop. I remember stomach aches all of the time, my entire life.  Things really ramped up in Jr High. After the hormones kicked in I had all of that and more.

I figured if I felt like crap then I might as well take crap care of myself.  So I started smoking and living off of processed foods.

Things got really interesting in college when I was nearly disabled from some mysterious anxiety/depression combo that crippled and almost drove me mad.  Along with it came some large weight swings.  For nearly 20 years I had a closet that ranged from size 4 to size 10, and I would just swing back and forth with the seasons.  Things got really bad after having my daughter in my mid-20’s.  Holy thyroid/adrenal/autoimmune issues!  (I later figured out that the weight swings were due to an autoimmune thyroid condition. Hyperthyroid, hypothyroid, back and forth, all the time, swing swing swing).

My physician (s) at the time just kept preaching the low-fat, high grain mantra and kept filling my mouth with an arsenal of pharmaceuticals (I joke that I did well later on in Pharmacology class because I had quite literally been on most classes of drugs that we were studying at some time in my life.  I personally knew all the side effects).  As I was nearly always trying to starve myself (because I couldn’t figure out why my weight was swinging and why my stomach always hurt) I became deficient in nearly every nutrient that I can think of.  Strangely, when I did not eat, I felt MUCH better…..that’s how food intolerances often work in people. Next time you see a young girl starving herself, before assuming that she’s just being difficult, perhaps ask her how her stomach and brain feel.

I am now often told now how great I look for my age.  Boy, if they could have only seen me 10-20 years ago when I was a puffy, autoimmune mess!  I am proud to say that my immune system is now in check (for the most part, it’s a daily conscious struggle), my body composition/weight has remained fairly stable over the past 8+ years and I generally feel good.  Sometimes I still feel horrid, and it’s ironic when you are autoimmune because no one can SEE anything wrong with you.  You end up curled up on the sofa, riddled with pain and anxiety, and no one understands because you “look fine”. Those days are rare anymore, they used to be the norm however and I will never lose sight of that, because I never want to go back.

How did I get my groove back and what does this have to do with fitness?

Holy smokes, that was a long haul back to any kind of groove.  I completed my Naturopathic and Chiropractic degree at the same time which nearly killed me.  I was unfit during most of the experience (how does one find time to sleep, let alone exercise when they are enrolled in 2 medical programs concurrently?).  So you take a skinny-fat* girl whose weight is swinging all over the place, you put her under enormous stress and make her sit on her rump all day in classes for nearly 6 yrs, and you throw in some decent spinal traumas, chronic ligamentous laxity due to autoimmune disease and poor diet, throw in a lifetime of fluroquinolone antibiotic use and POW!, along comes an epic car accident. What happens to said girl you ask?  Her tissues disintegrate off of her spine and she hurts ALL OF THE TIME.

Mind you, I’m tough.  I can endure a lot of pain.  I used to pride myself in not crying or flinching over broken bones as a kid and refuse care or when I’d get tattooed for 7 hours and not blink an eye. Now suddenly I was the princess and the pea, remember that story? I could literally feel every lump in my mattress, every ball of string in my clothing, I could no longer receive bear hugs because my spine hurt so badly.  I stopped eating, I stopped sleeping and I felt like I was dying.  It was 2003.

Fortunately for me I was surrounded by some amazing docs and interns at the two schools that I was attending . A few really pulled me through that swamp of terrible pain where every moment was an 8/10 pain.  I received a lot of passive care (that’s where your doc does something to you, like adjust your spine or inject you or massage you, etc).  Just as I was starting to improve from that car accident I had another major trauma to my spine.  I was literally crippled by it.  I would sneeze and my pelvis would unlock and I would crumple to the floor.  I had to brace myself when I coughed or laughed or sneezed, both hands on a wall kind of bracing, because I felt as if my pelvis and spine would shatter.  I was in a bad place and I was pissed off about it.  I was skin and bones at this point and looked like I was dying of cancer and yet everyone kept telling me how amazing I looked. That pissed me off even more.

It was at that point that I realized something EPIC and critical.  It occurred to me, as I lay crippled in bed on day 3, that I had to fix this.  No one was going to do it for me.  No therapy, applied to me by another doctor, was going to make enough of a difference to save my spine.  (Let me remind you that w/out a strong spine, one can not be a Chiropractor themselves, because it’s a full contact sport).  With my career on the line, not even out of school yet, and a completely unstable spine, I decided to act.  I remember crawling out of bed, crawling down the hall, opening a phone book and calling the Pilates studio down the street.

That moment saved my life, I firmly believe it. I tell patients daily that Pilates saved my life. It was in that moment that I stopped making excuses, stopped believing that someone else was going to fix this for me and started listening to my mentors and intern friends who had been barking at me to get moving!  I had made a million excuses to them as to why I could not move or rehab, etc.  I suddenly realized that if I didn’t get my stuff together I was going to be toast!  Pilates gave me my center of control back, physically and mentally.

“Move Your Buns Around”- Rick Marinelli, ND, MSOM

So began my journey into real fitness.  I had been formally and extensively trained in anatomy, biomechanics and rehabilitation in Chiropractic college. I knew what I needed to do, I just did not know how to integrate it into a simple and user-friendly format.  I’ve made a lot of gains in my fitness levels since 2003, I’ve experimented with a lot of techniques, exercises and ideas, worked with some great people. Running, yoga, Pilates, strength training, HIIT, boot camps, you name it.  Some of these did not work for me and my unstable pelvis.  Beyond just doing these activities myself, I’ve studied and learned and expanded my training in biomechanics, orthopedics, rehab, functional movement, Pilates, pain, neurological basis for pain, etc. I am a total geek about this stuff and I love to read the science, take seminars and experiment.

Some things are just not for me because my pelvis remains mildly unstable and that is ok.  I can’t do a lot of weighted squats, my back does not tolerate it, so I do other things to build my glutes that don’t hurt me. I can live with short runs on occasion and will never be a long distance runner, which is fine with me.  So long as I can outrun the zombies if they come around and climb up stuff when I get tired of running, I’m good!

I’ve also had a lot of regenerative injection therapy to my spine and pelvis which has made a world of difference.  My pelvis is still chronically unstable and hurts every day, but it’s a dull roar in the background of my otherwise awesome life full of healthy movement.

“I see dead people”

Not really, but I can see them on their way to the grave.  I tell patients all of the time that I can tell how fit someone is just by looking at them.  I think that anyone who is fit can do the same, it doesn’t take specialized training.  I have specialized training to look at things like gait, movement patterns, posture, muscle firing patterns, etc.  I can tell by how someone holds their skeleton up, their head carriage, their knee angles, their posture, how they bend down to tie either shoes with ease or not, I can tell how fit someone is just by looking at them. (I can also determine, within a few points generally, exactly where someone’s lab values are going to fall just by looking at them, that’s my Naturopathic training, and I’m usually spot on).  So yes, I can see dying people.  Because if you are not building tissue, you are genetically designed for degredation.

In my practice I do mainly musculoskeletal medicine, regenerative injection therapies, orthopedics and rehab.  That’s 99% of my work.  I treat joints all day long. I live this stuff.  I am the last stop after a long journey for most people, one that generally starts with their MD who tells them to rest it, the orthopedist who images it and tells them nothing is wrong or that they are not surgical candidates, usually shoots them up with cortisone then sends them to a PT who may or may not help them (the ones who see me were not helped).  If they are lucky they will find a good Chiropractor who will get them moderately improved and ultimately sends them to me for a consult for Prolotherapy.  They are often tired, frustrated and leery that anything will help at this point.  My main job is just convincing them to MOVE again.  Most patients are terrified to move the joint due to pain or perception of pain.  Treatment consists of rehab, nutrition and often injections (of good things to make your tissues heal, not cortisone which disintegrates them further).

This is where fitness comes in.  There are four categories of patients that I see: 1) The patients who come to me following a trauma, who were somewhat fit before the trauma, generally heal up quickly and efficiently. 2) The ones who were not fit and come in following a trauma are much slower to respond (that would have been skinny-fat me in 2003!) and often go into a chronic state if we are not aggressive with treatment.  3) The ones who come in chronic, but are fit, also heal more readily.  4) The last group are the ones who were never fit and are now very chronic.  Those are the toughest patients to treat and they generally spend a lot more money to get to a place where their pain is tolerable.

What about weight loss?  I could give a rip about weight loss, it comes as a side effect of good health and fitness generally.

I apply fitness to myself and my patients with a few main goals in mind: to improve function, stability, strength, balance and to decrease pain.  That’s it.  That’s why I work out nearly daily myself and why I am always telling my patients to get moving.  I can not recall the last time I told a patient to exercise to lose weight.  We know that exercise does not actually cause weight loss very well anyway (that’s mainly diet,  and a post for another day). Exercise does help you keep weight off, but it’s not the best weight loss aide.  My concerns in nearly every patient is function, stability, strength, balance and to decrease pain.

When I say “Unfit” I do not mean “Fat”.  I mean unfit!

As I am not a very big gal myself, when I talk about fitness in general, I am often misunderstood.  People are always shocked when I can lift something heavy or they grab my arms and feel strong muscles.  I may look small but I am mighty!

So I’m not talking fat, I’m talking muscle and cartilage and fascia and neurological movement patterns, not adiposity  Why fat even comes up baffles me.  More often than not when I think of someone “unfit” I think of all the skinny little vegan hipsters I see in Portland who end up on my treatment table with their ligaments torn to oblivion from a 35 mph impact in a car accident.  They just disintegrate because they don’t have the tissue integrity, strength and fitness level to withstand the impact.  Their bodies literally do not hold together as they would if they have been in some kind of decent fitness shape.  Size has NOTHING to do with it, if your tissues do not hold you together you are toast when it comes to injury.

I honor strength and people who do the work to enjoy the gift that is fitness.  Regardless of age or size or how their level of adiposity (fat cells)- if they do the work to keep their bodies strong and healthy, at whatever level they are able to achieve, they are enjoying the gift of fitness.  I thank my lucky stars every day that I have the tool of movement in my life to decrease my chronic pain and keep my immune system in balance.  It’s a gift that I take advantage of because it’s a powerful tool in pain reduction and longevity.  The work I do is very physical and I can do it well because of fitness.  It’s that simple. That’s the gift.  It has NOTHING to do with fat.

Do you enjoy the gift of fitness in your life?  Share your comments below and Happy 2014!

(*Skinny-fat:  A slang term in the fitness world to describe a person who appears small and, because of popular believe that small is healthy, appears healthy. They are, however, just bones and adipose (fat) tissue with very little muscle mass to boot.  They often suffer from the same disease processes that obese people do, namely metabolic syndrome/diabetes. The studies are showing  being “thin” with diabetes is far more sinister in the long run on your body than being obese with diabetes.)