The reasons for encouraging exercise are many.  Readers know that I am an exercise addict.  As a child, adolescent and young adult, basketball was my main addiction.  I remember deciding to stop playing at the age of 44.  As we age, we get hurt more and take longer to recover.  I hated giving up my favorite sport.  The joy of a great pass, or a clutch shot remains in my memory.

Over the next 20 years, I exercised intermittently.  I would go through periods of steady exercise, and then revert to extra couch time.  Over these years I gained more weight than was healthy or desirable.

I have reported on my return to regular exercise.  I lost almost 40 pounds, and have maintained that weight loss for over 2 years now.  I schedule my exercise religiously.

I should have done this all along, but it was just easy to pretend that I was still in reasonable shape.

One day it clicked and I became a weight loss and exercise addict.  The frustrating part of remembering that experience is that I cannot really explain to anyone else what triggered my positive lifestyle change.

So why did I write so long about myself?  I knew for many years that I should do more exercise, but I did not do it.  I knew the literature and risks, yet changing behavior required something to switch from off to on.

We know what our patients should do, but how do we flip their switch to on for exercise.

We can explain the benefits without much difficulty.  We can be good role models, and yet many patients will not follow our suggestions.

As a society we should strive to make exercise easier.  Too many patients live in situations where exercise is difficult and even potentially dangerous.  Our door-car-door existence does not help.

Given my current exercise obsession, I wish I could do a better job influencing my patients.  Any suggestions?