Win the Battle of the Bulge

You might just want to begin the new year with a healthier lifestyle.

Millions of able-bodied people struggle with unwanted weight. For spinal-cord-injury (SCI) survivors, the struggle may be even harder. Following SCI, the body’s metabolism changes: how we use food we eat and the fat we store is altered. In short, we use up less energy than we did before injury—and, the higher the SCI level, the less we seem to need.

We also know that lean body mass (muscle tissue) decreases after SCI. At the same time, the amount of body fat increases. In fact, much of the muscle tissue below the level of injury may be replaced by fat. This happens even if you don’t look or feel like you’ve gained weight. This is partly because you’re less active than before your injury, and partly because how your body works is changed by the injury. The result: It’s much easier to become obese, even by overeating just a little.

This combination of changed metabolism and decreased muscle mass, along with an often lower activity level, means that even the “Ideal body Weight” charts used by doctors and insurance companies may not be the best guides.

Several authors have reduced those charts by 10–15%. Using their suggested guidelines, the average 5'4" SCI woman should weigh 110–115 lb. The average 5'11" SCI man should weigh 145–160 lb. To figure your ideal body weight, find your height and frame size on an insurance chart, and subtract at least 10% from the weight given.

What To Do

Move past the denial. In one study of long-term SCI survivors, only half of those who had gained 20 or more pounds believed their weight was a concern.

Weight control—not gaining in the first place—or if necessary, weight loss, is what is needed. The two standard components of responsible weight management are exercise and diet. They work the same for able-bodied people and most individuals with SCI.

Yet, for some people, especially those aging with overuse injuries, exercise can be a problem. It may not be possible to maintain an exercise program capable of shedding excess pounds without risking new overuse injuries or aggravating old ones.

Diet, then, is your basic tool, and a sensible diet, though difficult, is possible.


People who are highly motivated can go straight to a strict low-cholesterol, low-fat, low-calorie diet. But most of us are better at negotiating: Keep the pie for dessert, but give up fast food burgers for lunch. Have that one beer with dinner, but then drink water instead of soda pop during the day.

Pick one or two things you are willing to do—and stick with them. Add others later.

Most motivated people, even those who don’t, or can’t, exercise, still can lose weight with diet alone. Finding that motivation is up to you!

Source: “Weight Gain: The Battle of the Bulge.” Consumer information from the RRTC on Aging with Spinal Cord Injury, Englewood, Colo.


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