Explore these tips for staying on track with your fitness goals, from fitness coach and psychotherapist Michael Gerrish. He joined us on Aug. 26, 2004.

If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

MODERATOR:
Welcome back to WebMD Live, Michael. We all know we have to move it or lose it, but so many Americans don't get any exercise or don't get enough. Why are we such couch potatoes?

GERRISH:
For those of you who are unfamiliar with my work, it's all about determining the hidden underlying obstacles that are preventing us from following through on an exercise program, sticking to a diet, or finding the energy to exercise consistently. I call these obstacles UFOs, meaning unidentified fitness obstacles. These are things most people don't talk about or don't know about, even a lot of medical professionals.

Examples are things such as:

• Hormone imbalances, which could include cortisol, DHEA, low testosterone, or thyroid candida, which is basically yeast overgrowth
• Seasonal affective disorder, or SAD
• Attention deficit hyperactivity disorder, ADHD
• Food allergies and intolerances
• Snack amnesia
• Insulin instability
• Sleep apnea
• Toxic relationships
• Perfectionism

Now, you can see when you look at this list that getting motivated to exercise has more to do with identifying the underlying blocks that are preventing you from finding the energy and motivation to exercise than it does with finding the right exercise or the right means of getting motivated.

MODERATOR:
That's a lot of obstacles! How do we go about determining which factors are relevant to our own struggle to get fit?

GERRISH:
The first thing I recommend is reading my book, TheMind-Body Makeover Project . In the book there's a 58-item test that will help you determine what it is that is holding you back. People can also start by keeping a journal in which they record their moods, their feelings during the day, whether they are mental or physical, their energy level, and their diet tendencies, anything that would help them get clues about patterns or trends that are sabotaging their success. With this information, they can approach an appropriate health professional who will help them to determine if there really are any of these UFOs keeping them from being successful.

So many people think that being motivated is about finding ways to overcome the fact they are inherently lazy, when in fact I believe this is very rarely the case. I don't believe people are by nature lazy. I think, instead, that there are reasons they feel lazy. For example, if you have SAD, or seasonal affective disorder, and it's not being treated, you can try every kind of motivational idea in the world and it's likely not to work. You need to treat the source of the problem, not the symptoms.

The same would be true if you have an underlying problem with depression or you're not sleeping well and failing to address it. Or if you have a hidden sleep problem, like sleep apnea, which will prevent you from having the energy that you would need to exercise consistently or well on a consistent basis.

MEMBER QUESTION:
I am so depressed and can't seem to get moving on anything. I know if I get out and walk it improves my mood as well as my body. Even knowing this, I can't get started. Then I feel worse. Why do I sabotage myself?

GERRISH:
It could be that you are suffering from a low-grade depression, in which case it would be a very good idea for you to consult with a mental health professional. The depression could be related to environmental factors such as lack of sunlight, emotional factors such as difficult or stressful relationships at home or at work, nutritional factors such as food allergies or intolerances, or even something as simple as a history of bad experiences with exercise.

The key, once again, is determining your individual underlying blocks. Until you do this, no amount of forcing yourself to exercise is going to work in the long term.

MEMBER QUESTION:
I am a 5 feet 2 inches tall, 42-year-old woman. I have lost weight three times. I have gotten to 116 pounds; however, my weight is beginning to creep back (120 pounds). How can I stay motivated? What can you suggest to read on nutrition and motivation? I don't exercise. I don't mind walking. Should I walk as soon as I rise in the morning or after I eat breakfast? Does timing make a difference?

GERRISH:
With regard to how to stay motivated, again, I think the main thing is discovering the reasons you don't feel motivated, which related to the UFOs I was talking about, but I know that people would also like some practical suggestions. So let me give you some of those.

• No. 1: Consider working out with a partner or trainer or joining an exercise class. A lot of people tell me they enjoy running or walking with their dog. So the key here is thinking outside of the box, in terms of what your options are.
• No. 2: Build on your success . Start with small, realistic attainable goals.
• No. 3: Reward yourself for reaching your goals. A reward could be something like a trip or vacation, a new outfit, a night out with friends, or a visit to a spa.
• No. 4: Keep a journal . Monitoring your progress will help you determine when and how to make adjustments over time. It will also give you clues about where you might be sabotaging your success.
• No. 5: Take a monthly photo to assess how your body is improving over time. Sometimes change is so gradual that we don't notice it unless we have some objective evidence that it did, in fact, occur.
• No. 6: Create variety . Mix things up to keep from getting bored.
• No. 7: Know your limits . Try not to do too much too soon. At first, when in doubt, always do less than you think you're capable of. Overdoing it the first few times around will set you up to fail.
• No. 8: Wear good shoes . Make sure they fit, are comfortable, and appropriate for the activity you're performing.
• No. 9: Make sure that your exercise program is performed at a convenient place and at a convenient time . This is especially true for you. If you force yourself to train early in the morning, even though it means not getting enough sleep or having less energy and focus than you would at another time of day, you might want to reconsider the time at which you work out.
• No. 10: Make sure that the program you choose is challenging, but does not feel like a grueling or long, arduous task .

I'd like to recommend a book, called Fitting in Fitness , by the American Heart Association. It has hundreds of great, practical suggestions for how to stay motivated to exercise.

MEMBER QUESTION:
Is it really worth the money to hire a personal trainer at my gym?

GERRISH:
It depends on the trainer. It also depends on your personality and whether or not you would enjoy working with another person on a regular basis. These are all important things to consider. I would suggest that you interview at least three trainers and that you make sure to check their credentials, including their education, experience, and specific background.

I would place the most emphasis on experience, working with individuals who have the same goals and concerns as you do. If it was I hiring a trainer, I would want to know that that person had been consistently helping people to address issues that I could relate to personally. Certifications are important, but I think less important than experience, personality, and educational background. Someone with a degree in physical education, exercise science, or exercise physiology will, in general, be able to offer you much more than a person who is crammed to pass a three-day test to acquire a certification.

MEMBER QUESTION:
Your book title intrigues me. I know I could get fit. I'm 37 and healthy, but just cannot stick to anything because of my ADHD, especially exercise. What might be some exercises or physical pursuits for someone with a short attention span who needs a new "twist" often to keep things interesting?

GERRISH:
As a matter of fact, in my book there are several case studies, real life case studies, involving people who had ADHD. For them, the solution was less about finding the right activities; it was more about treating the source of the problem, which was their ADHD.

Some of the people that I work with have seen great success simply by altering their diet, but more often than not if your ADHD is severe you will need some type of medical intervention, which may include the drug Welbutrin or some type of stimulant drug, like Ritalin or Cylert. Paradoxically, these drugs serve to calm and center people who have ADHD. Once again, the solution lies in dealing with the root of the problem.

MEMBER QUESTION:
Does Zoloft interfere with losing weight?

GERRISH:
Good question. Yes, it can. To affirm this is in fact the case, I would suggest keeping a journal for at least three weeks, in which you should monitor your moods, your energy level, and your eating patterns. Discuss the results with your physician and ask if he or she thinks there may be a more appropriate drug for you to be using. Not all medications work the same way for everybody. Many of my clients have had to try one or two different medications before they found one that not only worked well for them, but also had little or no side effects.

MEMBER QUESTION:
What's better for someone trying to make fitness a habit? A little bit of exercise every single day, or a bit longer every other day?

GERRISH:
The answer depends on the person. I would suggest you try both. Then you'll be able to see what works best for you. The answer is as simple as that. There's nothing that will form a habit for you better than achieving success. So the better something works for you over time, the more likely you are to persist. So really, the key is to find an effective exercise program.

MEMBER QUESTION:
How can I lose 10 pounds that I want to lose as soon as possible? I've been on my diet for seven weeks and I've lost 25 pounds but I have 10 to go and I want to lose them fast. It's taking me longer to lose these last 10 pounds that I want to get rid of.

GERRISH:
My question to you would be, how fast do you want to lose the 10 pounds, and why are you in such a rush? Because, the faster you lose the weight the more likely it is that you'll be losing a high percentage of muscle, as opposed to fat. Not only that, but you'll be slowing down your metabolism to the point where it would be difficult for you to maintain your weight loss.

I would strongly encourage you, for your health, as well as for your exercise program, to be patient and to take off the weight at a rate of no more than 2 pounds a week. You want to make your success last for the long term, not just for the short term.

MODERATOR:
How can you stay motivated when you hit a plateau?

GERRISH:
Again, it all goes back to identifying the hidden reasons why you're not motivated in the first place. For example, are you being limited by SAD, ADHD, a digestive disorder, a sleep problem, weak boundaries, work addiction, self-sabotage, or misconceptions about diet and exercise? These are the things you want to be looking at, because anything else that you do will only be addressing the problems in a short-term way or addressing problems that are on the surface.

MEMBER QUESTION:
Is there any home equipment you think is worth the investment?

GERRISH:
The best type of equipment for you to buy for your home is whatever you'll be motivated to use on a consistent basis. Again, this will depend largely on your individual preferences. I had one client who I suggested buy a recumbent bicycle and set it up in front of his TV set. That way, I knew he would use it on a more regular basis.

My favorite pieces of home equipment include power blocks, which are adjustable dumbbells, very versatile; elliptical cross trainer, which is fun to use and less stressful on your joints; and a lot of people tell me that they've had good results with a piece of equipment called the Bowflex, which, once again, is very versatile an easy to use.

MEMBER QUESTION:
What about bands. Good or gimmicky?

GERRISH:
Bands are good in a pinch, but there are far better options for increasing your strength and fitness level, such as free weights and conventional exercise machines. The reason I say this is because to increase your strength you need to progressively increase the amount of resistance you use over time. It is far more difficult to do this while using bands. Also, the type of resistance that the bands provide does not stress the muscle maximally throughout a full range of motion. So again, good if you have no other options, or if you want to exercise in your hotel room, but otherwise, stick to using conventional types of equipment.

MEMBER QUESTION:
I don't need to lose weight, but I need to gain energy. What kinds of workouts help clear the cobwebs best without necessarily burning calories?

GERRISH:
First of all, I think increasing energy has more to do with good nutrition and addressing any problems that may be causing you to have less energy than it does with finding an appropriate exercise. So if, for example, you have food allergies that you're unaware of, and they're sapping your energy, no amount of any new exercise is going to provide you with the energy you're looking for. You need to address your mental and physical status before you worry too much about the type of exercise to do.

MEMBER QUESTION:
Well, I do eat a lot of carbs. Could that be a source of sluggishness?

GERRISH:
Yes, particularly if you are insulin sensitive. If this might be the case, then you want to concentrate on eating low-glycemic foods like green leafy vegetables, foods that are high in protein, and foods that are balanced, in terms of protein, fat, and carbohydrates. Stay away from high-glycemic foods, like rice, pasta, refined foods, pastries, sweets, and the like. I also suggest that you try a low-glycemic diet (like the one in my book) for a few weeks to see if it helps your energy level.

MEMBER QUESTION:
I have fibromyalgia w/bipolar and wonder if bike riding or walking is good to do.

GERRISH:
Both are fine if you feel up to doing them. But you need to address, if you haven't already, your bipolar disorder first, because until you get that under control, anything else you try to do is likely to be hit or miss.

Most forms of exercise are good for people with fibromyalgia, but you need to feel motivated and energized before you can do any type of exercise on a consistent basis.

MEMBER QUESTION:
Are granola bars a high-glycemic food?

GERRISH:
Granola bars are high glycemic, and contain a lot of sugar. Although they have some nutritional benefit, I don't recommend them for people who have weight loss as a goal or for people who are allergic to grains. So if there's any possibility you have candida, or that you're insulin sensitive, or that you have food allergies or intolerances, I would stay away from granola.

MODERATOR:
We are almost out of time, Michael. Before we wrap things up for today, do you have any final words for us?

GERRISH:
Yes. If there's anything people should take away from this chat, it's that motivation is more about finding out why you don't feel motivated than it is about finding specific activities that will motivate you. Again, the problem is not that you're lazy; it's that you feel lazy due to real solvable problems that you need to discuss with an appropriate health professional. It's all about UFOs (unidentified fitness obstacles).

For more information about this, please go to my web site, at www.exerciseplus.com, or pick up a copy of The Mind-Body Makeover Project and be sure to take the test in chapter one. Most people who have done so have told me it's changed their life.

MODERATOR:
Our thanks to Michael Gerrish for joining us. For more information, please read Michael's books, The Mind-Body Makeover Project: A 12-Week Plan for Transforming Your Body and Your Life and When Working Out Isn't Working Out: A Mind-Body Guide to Conquering Unidentified Fitness Obstacles.