NEW YORK American trainer and health coach Lee Jordan likes to say his personal journey from 450-pound (204-kilogram) couch potato to trim triathlete began with a 30-second walk down his hallway.
After years of failed crash diets, hour-long treadmill workouts and fat camps, Jordan lost 275 pounds through a gradual and progressive program of exercise and diet.
He also had lap-band surgery, which reduces the stomach's capacity and restricts the amount of food a person can eat.
"People faced with making an extraordinary change think they must do something extraordinary but that's not the case," the 50-year-old said. "It's about doing the ordinary every day."
Indeed, for those who are very big, putting on their shoes can be a workout, he said.
Now a certified personal trainer, Jordan tells his mostly obese clients, through his business FullestLiving.com, that that routine is the secret to dramatic weight loss.
Jordan, based in Jacksonville Beach, Florida, referred to the frustration and concerted effort often involved in trying to lose more than 100 pounds by likening it to draining an Olympic-sized swimming pool with a small glass.
"You work exhaustively and the pool looks the same," he said. "Not only does it take a long time to lose the weight, but so much of it is playing defense: Resist this, resist that."
"After two weeks, maybe you've lost three to four pounds but you look exactly the same. It's frustrating."
Diet is crucial, but exercise is where the magic is.
Indeed, even after 10 days of a little exercise, he's seen people who were initially afraid of a trip to the mailbox walking six blocks and back.
"Exercise is a very pro-active thing," he said. "You're battling the dragon, not hiding from the dragon."
Five days a week, Jordan's workout begins with the boot camp he runs with his wife, Beth, who is also a fitness trainer. Three days a week, he does a version of High Intensity Interval Training - cardio training that involves bursts of high-intensity exercise alternated with low- to moderate-intensity recovery. He also runs.
ROLE OF FITNESS
The National Weight Control Registry, which tracks more than 10,000 adults who have lost at least 30 pounds and kept it off for at least a year, reports that 94 percent of participants say they increased their physical activity.
Like for many of his clients, Jordan's lap band has helped him control his food intake.
"The lap band is kind of like reading glasses. I need them to see the print but they can't read the book for me," he said, referring to the fact that discipline, in terms of diet and exercise, was still needed.
Indeed, half the people who have had lap-band surgery regain the weight because they haven't made the lifestyle change, he said.
Studies have shown that people who are unfit are two to four times more likely to die prematurely, regardless of their weight, said Dr. Barry Franklin, past president of the American College of Sports Medicine and director of cardiac rehabilitation and exercise laboratories at William Beaumont Hospital in Royal Oak, Michigan.
"Fitness is more important than obesity when it comes to outcomes" and the very obese typically fall in the bottom 20 percent of the population in terms of fitness and activity, Franklin said.
They also stand to reap the greatest benefits from exercise.
"It's not the person jogging 50 miles a week who tells me they're going to go up to 70 miles, it's the person who's doing nothing and starts walking, maybe 10 or 15 minutes who will typically show the greatest reduction in mortality, " Franklin said.
He said several studies in the last decade suggest that for substantive weight loss, people need to exercise 60 to 90 minutes a day. New studies also suggest that breaking it up into 10- or 15-minute segments may be superior to one long bout of exercise.
Both Jordan and Franklin stressed the necessity of wise nutrition and calorie intake.
"We counsel small steps over time," Franklin said.
For Jordan, it's about breaking the cycle of remorse and regret.
"It's about hope," he said. "People tell you when you're in enough pain you'll change, but that's not the truth. It might lead you to the door, but hope is the foundation of all change."
(Editing by Patricia Reaney and Bernadette Baum)