Posted by on Oct 9, 2013

Yoni Freedhoff, MD, is an assistant professor of family medicine at the University of Ottawa, where he’s the founder and medical director of the Bariatric Medical Institute—dedicated to non-surgical weight management since 2004. Considered to be Canada’s most outspoken obesity expert Dr. Freedhoff sounds off daily on his award-winning blog, Weighty Matters and is also easily reachable on Twitter. Dr. Freedhoff’s latest book The Diet Fix: Why Everything You’ve Been Taught About Dieting is Wrong and the 10 Day Plan to Fix It will be published by Crown in March 2014.

Visit Yoni on his websiteTwitterFacebook or Fitocracy

I remember my first bout of CE Syndrome (CES). I was 16 years old and not exactly a ladies’ man. My arms were basically pencils, my chest almost concave, and I realized that if I ever wanted to go out on a date, I probably ought to try to do something about them.  So I joined a local gym figuring it would likely be a good place to both let out some pent up frustrations, and to get to the necessary job of inflating my scrawny little body.

I hit the gym with as much abandon as someone barely able to press 80lbs could. I went 5 times a week, for 60-90 minutes a pop, and sure enough, after a little while, small plum sized biceps began to form and my chest could no longer sub in as a level in a pinch.

CES set in soon thereafter.

As is typical for new onset CES, it set in slowly.  At first my CES led me to miss just a few days here and there. But soon I found myself not going to the gym at all and in due course, those little plums I’d worked so hard at forging, quickly dried into prunes, and then, sadly but predictably, disappeared altogether.

And no, I didn’t date much.

I found the gym again during my first year of medical school. You might have thought that I’d learned my lesson living through my first bout of CES, but you’d be wrong, and despite hoping to rebuild those plums prior to performing on stage in front of the thousands of people who attend Daffydil, the University of Toronto’s health faculties’ charitable comedy show I was in, I ended up on crutches.

Over the years, I’d gotten much better at preventing CES and exercise has become a regular part of my life, yet CES and I have had a few more dances here and there. The most recent case was just over 3 years ago when despite feeling some twinges in my back, I kept on pushing and didn’t seek help. Fast forward a few months and I was embarking on what would end up being 6 months of near total rest and gentle rehab. And of course 6 months of active muscle atrophy.

So what is the muscle sucking awfulness that’s CES?

It’s Cyclical-Exerciser Syndrome and it crushes dreams just as quickly as it deflates muscles. And it’s likely the most widespread gym based malady around.

CES has many triggers, but the three most common are:

  1. Exercise time over commitment (my first bout of CES)
  2. Too heavy too soon (my second bout of CES)
  3. Ignoring warning signs (my third bout of CES)

In all cases though, CES’ destructive course is the same: First you stop going to the gym, then you slowly watch your gains, your strength, and your endurance disappear – a process that’s often so discouraging, it perpetuates the vicious cycle of taking longer breaks from exercise than needed for fear of having to take what you know from experience is the long hard road back.

While gym regulars have probably all already worked out their CES triggers and demons, newbies are the folks we have to look out for, especially those of us fortunate enough to have jobs that involve introducing (or reintroducing) patients or clients to exercise.

Setting someone up for CES and failure by creating an overly aggressive program might increase a person’s short term excitement and their word of mouth marketing of your tough as nails training, but you wouldn’t be doing them any great service. In my practice, especially as they’re just getting out of the gates, I encourage my patients to use lighter weights than they think they can handle and to purposely keep their intensity levels lower than their adrenalin might demand. Doing so allows them to learn safe and proper technique while simultaneously acquiring a base level of fitness – two hugely powerful drugs for the primary prevention of CES.

[BTW – CES can be beaten. The small peaches I sport on each arm are a testament to moderation, consistency, and listening to both my life and my body before heading to the gym.]

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