The times I least want to hit the gym are when I know that I need it the most. I have been that person who sits outside the gym in my car, contemplating whether to go inside. I have taken that power nap with the hope of waking up energized and prepared. I have also been the one emerges from both scenarios, only to drive home and submit to a more satisfying nap. I know what it feels like to regard physical activity as an elusive and uninspiring project. I also know how it feels to live hopeless and depressed, as opposed to invigorated and resolved. So, as a physician, when I appeal to my beleaguered patients and enjoin them to get to stepping, I know I am asking for a lot, but I also know why.

Exercise reduces weight, which in turn reduces the onset of hypertension, diabetes, arthritis, obstructive sleep apnea and early death. Your doctor measures your weight and determines your body mass index. We use a scale that places us as normal BMI, overweight and obese. Zones above 40 place individuals in critical mass categories that heighten risks for cardiac death and stroke. Numbers do not lie. Exercise can be a safe and inexpensive cure.

Let us talk about the positive aspects of exercise – the why of movement. I want you to remember how it feels after a good sweat, a decent run, or a few rounds of boxing the bag. Try to put yourself in the place of that endorphin rush after a good sweat. It feels really satisfying. It feels like a drug. It feels like it should: energizing.

The truth about exercise is this – physical movement liberates endorphins – chemical we release when we are intimate, joyful, dancing, excited, laughing. Endorphins are defined as chemicals released by the pituitary gland as well as the central nervous system which play an important part in our ability to manage pain and experience pleasure. When released, these chemicals help us to relieve pain, reduce stress, and can elicit a feeling of euphoria – physical and emotional ecstasy. Endorphins do a body pleasurable good.

Exercise strengthens bones and muscles. As physicians, we teach our menopausal women lacking estrogen support to maintain their bone integrity with calcium, vitamin D and isometric exercises. Heavy weight is not a necessity in the building of healthy bone and muscle. Jumping or running are also not requisite. Exercise of any variety and to any capacity is healthful – it is that simple. Movement strengthens bones and reduces osteoporosis or bone fragility.

Exercise improves symptoms of anxiety and depression. The feel-good hormones liberated with dance, running, swimming, walking all liberate serotonin, dopamine, and norepinephrine. Exercise makes us feel happier. When we are happy, we are more likely to move and engage in exercise again, and again. The desire to get up and move in the morning proves that much easier. Activities of daily living become possible. If you pick something you enjoy, you are more likely to succeed at it and to feel good after the endeavor. If you choose to run and you hate running, you are more likely to release cortisol – a stress hormone – as opposed to a pleasure chemical. But if you like to dance, choose Zumba, or dance in your home; you are more likely to feel a neurochemical rush of goodness that comes with dopamine. Blast your favorite artist and shake your body down to the ground, elevate your heart rate, smile, and let the purple rain flow.

Social interaction can also supplement the healthful benefits of exercise. Hitting your favorite group class in a Covid safe way allows you to interact, possibly push yourself to a different level than you might have on your own, while feeling connected.  Even as COVID has tested the resolve of millions of Americans, the imperative of movement is stronger than ever. 520,000 Americans have lost their lives, and millions more suffer with chronic Covid symptoms like fatigue and foggy brain. Last year, statistics revealed that 40% of women in America, and 20% of men admitted to gaining weight. Fear of communing forced people indoor and restricted movement. But getting outdoors, or in safe gym spaces with limited numbers and use of mask cannot be underscored enough. Do not let the pandemic alter your understanding of the benefits of exercise, because none of that has changed.

Mental clarity improves with exercise as well. We know that we can stave off dementia with regular activity. The release of neurotransmitters to include GABA and glutamate are responsible for messaging in the brain. Keep moving physically with the goal of remembering names and engaging in human interaction with greater clarity.

Time to talk about the obvious: rising weight and diminished physical activity leads to the onerous, painful and expensive diseases that have been cited.  The cost of diabetes in this country is on the order of billions. The ramifications of hypertension include stroke and heart attack, diseases that can debilitate for years, accruing costs of care, medication and repeated hospitalization on the order of billions as well. Exercise offers a fiscal and physical reward. The rising cost of healthcare and the lack of collective access make death from diseases like obesity and uncontrolled hypertension inexcusable and truly avoidable.

My advice: keep on moving with an eye toward living longer and living well. Clothes fit better, the mood feels right and the desire to engage in human interactions like sex, conversation and social gathering all improve with exercise. As a doctor, I try my best to model the behavior I seek from my patients, with empathy for the level we all reside at and a constant funnel of encouragement for those who seek it. I close with my favorite mantras: If you don’t buy it you can’t eat it. Get to stepping: 10,000 steps a day burn a pound of fat a week. Stay in your lane: avoid the chips and soda aisles and walk around the grocery store, not within its pantry filler lanes. If you imagine it, you can achieve it – put a picture of your fit you, or your doppelganger and model the behavior that gets you in those favorite jeans. You got this, just keep believing and keep on moving.