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A Heavy Subject

Watch the news any day of the week and you will see a story or headline about the rapidly increasing rate of obesity in America. We are all familiar with the alarming number of morbidly obese patients to whom we must render aid. While it is already challenging enough to provide care to this population, the co-morbid factors associated with obesity make moving and treating such patients even more difficult. Providing additional manpower to calls, purchasing equipment specifically for heavy patients, and designing vehicles and protocols exclusively for an obese population have put quite a strain on our health care agencies, let alone our backs.

However, many of you also fall into the obese population. Because of this, your risk of injury, falls, and medical problems is far greater than that of your normal BMI counterparts. For some reason, public safety professionals live in a self professed bubble of the ‘it won’t happen to me’ mentality. I’m sorry to tell you that not only is this blatantly untrue, but the stress and poor posture acquired on the job actually increases your risk of poor health. As an employer, the cost of rehabilitating an obese employee is much higher than someone of a normal weight.

While on duty, your joints sustain an incredible amount of strain while your biomechanics alter to allow ‘normal’ movement, thereby leading to injury. If you look at the bottom of your shoes, you will notice that the wear pattern and sole breakdown from walking on the outside of your foot is clear, and the compressive strain it places on the inside of the knee is extreme. This leads to rapid joint degradation, further altering your biomechanics and forcing changes at the hip and spine. I hope you get the idea.

The first step to reversing this trend is to change how you act and think.

1. Portion Control. This is by far the easiest way to lose weight without changing much. Simply eat less of what you normally eat. A good rule is that nothing should be bigger than your fist! By cutting calories, not only are you saving money, but you are also shedding excess pounds.

2. Avoid Sugars. As I have said in columns before, “If it’s white, do not eat it.” Simply stated, the simpler the sugar, the more chance your body has to store it as fat. Substitute whole grains and avoid processed foods. The more the grain is processed, the more good stuff is removed. Something must be added to take up the space, and that something is usually sugar.

3. Move. Sounds easy, right? This is an excellent chance to change our thought processes. Make everything an exercise: walking stairs, cleaning your unit, doing chores, and carrying and lifting patients and gear. Any activity that can burn a calorie will reduce body fat. Simply walking laps around the station, doing step-ups on the step plate, or throwing around a Frisbee will burn calories and pass the time between calls.

4. Goals. I generally do not like goal setting, especially with weight loss. That said, however, one of my favorite games to play is asking for a new uniform in one size smaller than your current one. Your goal is to fit in it comfortably after 2-3 months. I can assure that your employer would rather pay for a new smaller uniform than the injury and lost work time that will occur if change does not come.

5. Fitness. Research clearly shows that sustained exercise at a consistent (not strenuous) pace performed 4-5 times per week will increase your metabolism and shed those unwanted pounds. The common mistake I see is trying too hard, too fast. Let’s be honest. You’re in poor condition, so please do not go out and kill yourself in the first week. Fitness is a lifestyle; the more consistent you are in your exercises and movements and the longer you do them, the greater and longer lasting the weight loss.

6. Make better food choices. Simply choosing better foods will go a long way toward reducing your caloric intake and helping you to be healthier. Check out my good/bad food list to aid you in your decisions.

As the first contact for the public in its moment of need, we have an obligation to not only look the part, but also to be fit enough to perform the basic functions of the job. Public safety is a very strenuous job. We are required to lift and carry excessive loads numerous times throughout the duration of our shift. It is your responsibility to be fit, strong, and healthy enough to do the job of which we are all so proud. Make simple lifestyle changes, feel better about yourself, look better, move better, and you path will become one of the caregiver you are, not the patient you were destined to become.

Bryan Fass, ATC, LAT, CSCS, EMT-P (ret.), dedicated over a decade to changing the culture of EMS from one of pain, injury and disease, to one of ergonomic excellence and provider wellness. He leveraged his 15-year career in sports medicine, athletic training, spine rehabilitation, strength and conditioning and as a paramedic to become an expert on prehospital patient handling/equipment handling and fire-EMS fitness. His company, Fit Responder, works nationally with departments to reduce injuries and improve fitness for first responders.

Bryan passed away in September, 2019, leaving a legacy of contributions to EMS health and fitness, safety and readiness.

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