Exercise as medicine philosophy spreading
Live Well clinics employ rehab principles to create a lifestyle
For as long as she was a politician, and before that as a family doctor, Margaret MacDiarmid did little in the way of active physical exertion.
She was, she readily admits, “one of the most sedentary people ever born,” content to spend leisure time reading in a comfortable chair or playing the piano.
But after she was defeated in the 2013 provincial election, the former B.C. Liberal health minister decided it was time to finally embrace the exercise as medicine movement and reclaim her own health.
With a history of breast cancer and meningitis in the years before retirement, the now 60-year-old set as a top priority the restoration of her body and soul, the latter battered by the health-researcher firing scandal she inherited the day she was appointed health minister in September 2012.
She would spend the next few years after her defeat fending off lawsuits over the scandal (eventually dropped), volunteering, going to her cabin on Kootenay Lake, doing peer counselling for cancer patients, and serving on the board of Vancouver Coastal Health.
It was while reading a Vancouver Sun story in 2016 that MacDiarmid learned about Live Well Exercise Clinics, which specialize in supervised physiology programs, both for those who have had heart attacks and other health problems, and for those seeking to prevent conditions like diabetes, high blood pressure, cardiovascular disease, and complications related to obesity.
“At the time, I was not very active and it was the gloomy winter. I read about people who were transforming their lives from a health point of view. I loved the idea that people go in and get an individualized exercise and lifestyle prescription,” MacDiarmid said in a recent interview in the Sun newsroom, an east Vancouver location to which she cycled more than 10 kilometres.
“If you had asked me just a few years ago to come and see you, there’s no chance I’d ride a bike to get to our meeting. But now, it’s tough for me to get in a car,” said MacDiarmid, who credits her Live Well clinic membership with getting her strong enough to walk a hilly golf course (Kokanee Springs) and being able to downhill ski for the first time in decades.
Sara Hodson, the president and founder of Live Well, got the idea for a chain of clinics in the sweet spot between medicine and fitness when she was working as a certified clinical exercise physiologist at a cardiac rehab centre.
Such publicly funded clinics are attached to about a half-dozen hospitals in B.C., she said, but patients typically use them for only 12 to 24 weeks. Hodson observed that a year after patients stopped their cardiac rehab programs, less than one per cent were still exercising. Lost on many patients are that they must exercise for life to prolong their lives.
“People tend to see this rehab as a short-term intervention when they should be seeing it as a longterm commitment to exercise. In other words, if you don’t do it, the repercussions are that you can get sick again, sort of like if you stop
I loved the idea that people go in and get an individualized exercise and lifestyle prescription.
taking birth control pills, you’ll get pregnant,” she said.
Hodson launched her flagship Live Well clinic in Surrey in 2011, first of its kind in Canada. A second opened in Kerrisdale in 2013. Many more have opened in B.C. through franchising. And Hodson’s partner, franchising expert John DeHart, is now branching the enterprise out across the country. With the medical establishment uniformly chanting the “exercise as medicine” mantra, up to 70 per cent of clients are being referred by doctors.
Almost 1,000 doctors in B.C. and Ontario have reportedly referred patients — mostly baby boomers — to the clinics for lifestyle and fitness coaching.
MacDiarmid says there’s no excuse not to stick with the program since it’s affordable (about $20 a session), never too crowded, highly personalized and highly effective. Kinesiologists and exercise physiologists not only design programs for each member, but also monitor individuals working on aerobic capacity, strength, flexibility and other goals.
“I’m truly inspired by the people I meet there. People who once qualified for bariatric surgery but no longer do because they’ve lost so much weight, people like me who now have blood pressure and blood glucose levels as low as they were in my 20s. I’ve seen people who were taking medications for diabetes reduce their dosages or stop them altogether. You rate your mood and energy levels when you arrive at the clinic and then again at the end. Of course, it’s always better at the end,” MacDiarmid said.
Tory Brooks-Hill, clinic director at the Kerrisdale location, said physicians are kept informed about their patient’s progress on exercise capacity, weight, body measurements, blood pressure, and heart rates. Vital signs are monitored by clinic staff, all of whom have degrees in exercise science.
While weight loss is a goal for many, clients are reminded that muscle weighs more than fat, which is why waist circumference is a better measure.
Grant Cameron, a 65-year-old who had a heart attack just over two years ago and had stents inserted into blocked heart blood vessels, started his rehab at the Live Well clinic because he was wait-listed for rehab at the Vancouver General Hospital clinic. Doctors told Cameron, who had no risk factors or symptoms before his attack, that his best option for recovery and preventing another attack was to get more exercise.
Cameron said he’s in better shape now than 20 years ago. His wife attends the Kerrisdale clinic with him twice a week. Their fees are considered a tax-deductible expense, given that they have a medical prescription for the sessions.
Hodson said she knew she had to design an exercise and education model that would keep clients engaged.
“We hope people don’t wait to come only after they get sick. Exercise is a miracle drug. People should do this to prevent chronic conditions, to focus on themselves. We are not about the push-pushpuke approach,” she said, referring to some gyms that push clients to the maximum.
She’s proud of company statistics showing retention at the clinics is about twice that of conventional fitness centres.
“At six months, 84 per cent of clients are still with us and at one year, the rate is 73 per cent,” she said.
Hodson, a frequent public speaker on health behaviour prescriptions, said the Live Well clinics are the first gyms to conduct an internal study on members.
The as-yet-unreleased results prove that exercise improves blood pressure and weight management, she said.