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Beyond the Prescription
Natalia Petrzela on America's Fitness Obsession
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Natalia Petrzela on America's Fitness Obsession

Exercise is About More than Weight Loss & Worthiness

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Leading political and intellectual historian and certified fitness instructor, Natalia Petrzela, firmly believes that exercise matters not only for our physical health, but mental health as well. Yet while we as a nation are obsessed with exercise, too many Americans are sedentary. Many of us equate exercise with losing weight—but health is about more than the number we see on a scale.

Natalia is also the author of Fit Nation – The Gains and Pains of America’s Exercise Obsession, which shows how fitness in America is about more physical health—it’s a means for equity, inclusivity and community-building.

Natalia joins Dr. McBride to discuss America’s complicated relationship with exercise; why it’s so important for our overall health to prioritize movement; and how we can become healthier from the inside out.


Join Dr. McBride every Monday for a new episode of Beyond the Prescription. You can subscribe on Apple Podcasts, Spotify, or at lucymcbride.com/podcast.

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The transcript of the show is here!

DR. LUCY MCBRIDE: Hello and welcome to my office. I'm Dr. Lucy McBride. And this is Beyond the Prescription, the show where I talk with my guests like I do my patients, pulling the curtain back on what it means to be healthy, redefining health as more than the absence of disease. As a primary care doctor for over 20 years, I've realized that patients are much more than their cholesterol and their weight. Our stories live in our bodies. I'm here to help people tell their story, and for you to imagine and potentially get healthier from the inside out. You can subscribe to my weekly newsletter at Lucy McBride Ockham's Newsletter and to the show on Apple Podcasts, Spotify or wherever you get your podcasts. So let's get into it and go beyond the prescription. For most people, the relationship with exercise is complicated. We feel better after we've exercised. We know we should exercise more. But there are a lot of barriers to getting out the door. Today's guest is historian, writer, fitness instructor and associate professor at the New School in New York, Natalia Petrzela. She's just written a new book called Fit Nation The Gains and Pains of America's Exercise Obsession. Natalia joins me today to talk about this complex relationship with exercise, fat shaming, body image, diet, culture and why it's so darn hard to get the movement we know we need. Natalia, thank you so much for joining me today. 

NATALIA PETRZELA: I'm so happy to be here. Thank you for having me. 

DR. LUCY MCBRIDE: Well, you and I have become friends via Twitter, which is this place I have a love hate relationship with, like so many. What I have loved about it is learning from people like you and people in academia and in particular, learning about how people conceptualize health in a more robust way other than thinking about health as just about our blood pressure and our weight, for example. As you well know, as a doctor, I recommend exercise to people every day. But it's not just about me recommending exercise to people. It's not just about me saying, Hey, exercise more. See you later. See you next year. Good luck. It's about understanding what is the relationship with exercise the person has? What is their access to realistic, sustainable ways of moving their body? And it's about finding out what they love, what they like to do. I can tell people all day long to start cycling, and if they don't like cycling, then what's the point? I want to start by asking you, Natalia, as this book is being launched, could you go back to where your interest in exercise began? Because I think you were a fitness instructor well before you were a historian. And just tell me about your background. 

NATALIA PETRZELA: Yes, absolutely. So it goes way back and I promise not to tell you this beat by beat because it would take so long. But it actually goes back to high school and to the fact that I was not athletic and I was just very intimidated by P.E. class and by organized sports. And so what actually happened is that I found out one day that you could get an independent study credit in P.E. And so I like go to the head of the department with this like Student Rights and Responsibilities manual. I still remember. And I was like, I want to do this basically, anything to get me out of the humiliation of phys ed class. And they're like, No one's ever asked about that before, but like, we'll look into it. I'm like, It's in the book. It's like a big public school. And so basically they came back. This was 1994, I think, and they said, Well, you can go do personal training or you can take a group fitness class. So I go to my parents and they're like personal training. We read an article about that in the paper. I think that's what rich people do. Like you're not doing that. And then they said, Well, we belong to a Jewish community center and they have group fitness classes there. So you can go do that because it's part of our membership. So long story short, I was like 16 years old. 

NATALIA PETRZELA: I found step aerobics class and I, like, fell in love. Like first I just went and did it because it was better than P.E. And then I realized, like, here is this space where I'm in my body. I'm like, getting muscular, I'm having fun. Like, I just, like, came alive in a way that I hadn't I had always thought, like, I'm lucky, I'm smart and I have my mind and my body is pretty healthy. And so, like, it just carries around my mind, but I'm not going to pay attention to that part. And so that's like a long, early part of the story. But then it was always like the kind of gym world, not sports at all, but the kind of gym world was really a passion for me. And so it was sort of karmic because I was this very like cerebral academic kid who was always also kind of a gym rat. And when I moved to New York City to go to college at Columbia, I immediately got a job working the front desk at this big health club so I could get a free membership and take these great classes. And then I ended up after, like in graduate school, getting certified to teach this workout class, which I still teach today, even though I'm a full time history professor. So that's like a short version of very long story. 

DR. LUCY MCBRIDE: I love it so much and I love that moment or set of moments where you realized that your body wasn't just a container of your organs and that moving it and challenging it and getting it stronger or becoming stronger was actually improving how you felt physically and mentally. And that's for a lot of people. They don't believe that's possible or they haven't even conceptualize what that might look like. It's also not to say that everybody needs to be a fitness instructor or be obsessed with exercise, but I wonder how you would answer this question. Natalia How do you conceptualize health? 

NATALIA PETRZELA: Yeah, it's a great question. I would say that for me, health is about more than the absence of illness. 

DR. LUCY MCBRIDE: Oh, my gosh. Wait a minute. Sing it, sister. This is what I say every day. I know. 

NATALIA PETRZELA: Well, I learned so much from you, too, by the way. You're a little intro there. My feelings about Twitter in general are very similar, and about you in particular are very similar. I learned so much from you. Feel very like simpatico with you. But yeah, to me, health is about more than the absence of illness. And it's about, you know, the kind of like integration, to use a cliche of like body and mind. To me it's also about like, you know, finding the appropriate balance between like taking sort of control and initiative and agency over your own health and 

appealing to experts like yourself. When a run isn't enough to solve whatever I'm going through, I actually need the expertise of a doctor to prescribe me and diagnose me and prescribe me. And that balance, all those things are about finding balance. It's not easy. It demands a lot of reflection and kind of attention to oneself, but I think all of it is important. And so often we're missing at least one piece of the conversation. 

DR. LUCY MCBRIDE: You just said everything I am trying to say and other outlets so beautifully, and I think this is where we overlap in terms of our interest. I think it's also in part why I like you. I mean, there are other reasons, but I think that. When we think about exercise or when the general public thinks about exercise, they often think about the drudgery, the shoulds, the oh, and then they also think about exercise as a means towards losing weight. I've just done a series in my newsletter which comes out weekly about weight loss and the myths around weight loss, because as you well know, we focus so much on the number on the scale where we have this obsession with weight and bodies and body image in this country and then exercise gets thrown in there as this sort of means to an end. But actually exercise in and of itself has myriad benefits beyond weight management. So when you're talking to someone in your Fit Nation class, for example, who maybe carries extra weight or wants to lose weight, and you talk about exercise, how do you describe that relationship? 

NATALIA PETRZELA: Oh, it's so complicated. So because on the one hand, we have had decades of really damaging messaging that I think one holds up weight loss as like the end all be all of health and that the main goal of exercise or diet modification should be losing pounds on the scale like I'm not that kind of doctor like you but even I know that that's overdetermined and really damaging and like puts an undue sort of emphasis on the quantification of something that is not only a quantifiable metric. So there's that. And so some people, I think, really kind of need that advice to kind of realize that this has been socially constructed and sort of like not emphasize so much the weight loss aspect of things. On the other hand, and I think this particularly applies to like the kind of students who show up in a college class of mine around Fit Nation who are sort of like very hip to kind of more progressive ways about thinking about the body, etc.. Some of them almost have another insecurity, which is like, Oh, if I want to lose weight, that means I'm like being a slave to the patriarchy, or I've just like internalized these oppressive standards and like, I feel that I want to lose weight, but I'm almost like embarrassed to admit it because, like, that's being sort of a sellout. 

NATALIA PETRZELA: And I think that's a really complicated feeling that I reckon with as well. And I try to be really honest about. And the way that I kind of try and reconcile those is really to realize that, you know what sometimes, maybe even often weight loss and is an outgrowth of other healthy behavior changes. And so I think what I try to do for myself and I don't give medical advice, I leave that to people like you, but I try to like in part it's like, what if we thought about weight loss as something that can be really good but isn't our ultimate goal? So if your goal is to eat fewer processed foods, to move more rather than to lose £5 or whatever, for me, that's like pretty inspiring in terms of being realistic about the fact that weight loss is sometimes an appropriate goal, but not obsessing over that as the end all be all because that's really unproductive and I think often unrealistic or at least unhealthy. 

DR. LUCY MCBRIDE: You're so right. I mean, so many of my patients who struggle with obesity or overweight, which is, of course, potentially a medical problem, I mean, we all know that extra weight can promote diabetes, high blood pressure, cardiovascular disease. So there's no pretending that obesity has risks or potential risks. And I think that's one of the challenges for people, is that, as you said, we are now in this mode of like body positivity and we're so aware of fat shaming, which is just a crime against humanity that I think people who want to lose weight sometimes do feel like, oh my gosh, I'm just a victim of, as you said, the patriarchy, when actually two things can be true at once. You can need to lose weight for your health and you can think about health as more than just the number on the scale. So when I'm counseling a patient about weight loss because they have diabetes and they need to lose however much weight, I say, look, let's not focus on the number. In fact, I'm a big believer in throwing away the scale. Let's not focus on the number. Let's focus on the behaviors and how you feel in your body. For some people, they feel worse when they exercise. They hate it. They don't want to do it. And I'm like, Well, that's good information. Then they feel so much better when they limit processed foods. When they cut back on alcohol, they might be annoyed at me that I made that suggestion, but they feel better. And so it's really about tuning into how you feel in your body and then focusing on the behaviors and the habits and then giving yourself permission to not be consistent every single day, because that's not really compatible with humanity to be perfect. 

NATALIA PETRZELA: So much of what you're saying resonates. I mean, one thing which I think is really heartening to hear from you, a physician who's seeing people is like, I've read so many really eye opening accounts of fat people who encounter medical discrimination who go to the doctor. Yeah. And either there's this sort of like everyday trauma of being put on a scale and either being told, you know, in extreme cases that scale like, won't even fit you. This one woman was talking about being sent to almost like a like a zoo to be weighed like with literally a scale meant for animals. But also like, you know, there are all these people who are saying like, well, I. Reserve the right to not be weighed or to not be told the number on the scale. And I think that's a really compelling case, as well as these stories of folks who like go in with legit problems and are just sort of brushed off and told, well, obviously you just need to lose weight. And so I never want to diminish that experience and it's just good to know that you're doing that work. So I think that is like just so important and, you know, outside of my practical field, but really important to how I think through these things. It's interesting that you talk about like a lot of people like hate exercising. And I agree with you, as we were talking about early on, like the need to kind of find something that you like, I think because you won't stick with it. I do think that balance between something that's hard and something that feels good is really hard to strike. 

NATALIA PETRZELA: And sometimes it's even a false dichotomy because sometimes the thing that is hard doing it will make you feel really good. And I often talk about this when people talk to me about my are asking me about like, Well, what's your fitness routine? You seem so like gung 

ho on exercising. To me. It's like really checking in with the way that exercise different kinds of exercise make me feel. And knowing that on different days, the sort of need different things. So for example, I am like not a quote unquote like natural runner or whatever that means. Like it's never come easily to me. I'm not particularly fast. That being said, I have in my life now run, I think, four marathons, three marathons and a whole bunch of hops. And here's the deal. It is so hard for me to get out there and do those runs, but it is so satisfying to me when it's the right moment for it to have completed that, that it's just like it's a great thing, like it really is, even though it's really hard. So there's that. But then there's also like a lot of days where I'm like, okay, I like will not work out unless it's going to be pure fun. And I go to like a cardio dance class or I go for a walk with my husband or something that's just like very low barrier to entry. And to me, like, that's better than nothing. And it's the thing that's going to happen that day, that day of five mile run is not going to happen. So like, let go of it and don't feel bad if it doesn't happen. 

DR. LUCY MCBRIDE: Absolutely. It's about being intuitive about how you move your body and not punishing. It's about managing your own expectations, being realistic. And then for many of my patients who say they don't like exercising or they do this, which is not to make fun of my patients because we all have avoidance behaviors in one way or another. They'll say, Dr. McBride, I can't exercise in the winter because it's too cold in the spring because of the pollen and the summer is too hot. And then the fall there's the ragweed leaf mold. And I'm like, okay, are you going to move from D.C. where those seasons aren't happening? Or are we going to try to unpack what you're actually avoiding here? And for some people and I tease my patients, the ones that I have a good rapport with, I'm like, let's unpack what that is, because that's avoidance behavior right there. There's something else going on. And if you ask enough questions and have enough time, you understand that people have been shamed by fitness instructors. They have been shamed by the medical profession. I mean, it is so common for my patients to come in when they were new patients to say, I have been so shamed by doctors, or you can just tell they've been shamed by doctors about their weight when as you and I both know, weight gain and obesity is not a personal failure. 

DR. LUCY MCBRIDE: We need to reframe it as the complex sum of societal, cultural, nutritional, behavioral, psychological, medical features. To treat a complex problem, we need complex solutions. And part of that involves taking away the shame about our bodies and being like, Look, there is no shame about this. We could all be ashamed of things all the time. When you shine a light on what the various facets are that comprise your weight, let's then chip away at this problem one bit at a time together. And so I guess what I'm saying is the relationship with exercise for so many people is really complicated. And I think when they look at it under a microscope, they then give themselves permission to try things and be less punitive or less rigid about not doing it. 

NATALIA PETRZELA: I totally agree. And it is finding that balance between the structure to kind of push yourself to do hard things and to make time for that and being forgiving. I think that's so right. And, you know, having now studied the history of exercise in the United States, really for centuries, but even more recently in terms of just decades, it is very recent that anybody is talking about exercise as anything but kind of punishment. I mean, I was reading recently about like a bunch of news articles that were kind of talking about New Year's resolutions in the 1980s. And it was like asking people, what are your New Year's resolutions? And, you know, the most popular one is I'm going to exercise, which is consistent with today. What is remarkable is hearing every person in that article talk about exercise as like the worst experience, like I have to get up before dawn to run because if I'm semi-conscious, I could never endure that torture. Or I envision my jiggling fat in my bathing suit this summer. And that like forces me out the door. My dad died of a heart attack. So if I don't want to come to like a terrible, untimely death, I will force myself to exercise. I'm like, This is the worst way to go about it. 

DR. LUCY MCBRIDE: Just no one. Her people have this relationship with exercise that's so punitive. 

NATALIA PETRZELA: Yeah. And I mean, just think I purposely the subtitle of my book, The Gains and Pains of America's Exercise Obsession puts Gains Before Pains, because I like to, like, promote that. But also, we have had a no pain, no gain mentality in this country around our discourse, around exercise, like forever. We still have it. And I think we are sort of gently moving past that. But it's slow and it really helps explain why so many people don't want to or like feel really resistant and even traumatized participate. One of the other things that I found also is that when I would say now for almost a decade that I'm writing a book about fitness in America very frequently among people who are older than me, like in their sixties or so, they would immediately respond with some traumatizing experience of physical education class, like unprompted. It's like the memory was right here, just like, waiting to spill. 

DR. LUCY MCBRIDE: Like what? Like what do people report commonly? 

NATALIA PETRZELA: A lot of people report that kind of like performance of their physical inability in front of a class. And I even kind of remember that like, okay, now everyone's going to do the rope climb, get in a line. And like, I remember and other people describe like, you know, like holding, not being able to pull yourself up and like having someone mark you as unable to perform that. That's something that people really remember. And then just that whole sort of like quantification around like how fit you are. And also doing it publicly is something a lot of people really remember very negatively. Another really important piece of those memories that people had was also exercise being used as punishment, something that I still see today, quite a bit like, Oh, you're talking ten pushups. If you don't behave, you're going to have to run five laps. And like one of the things that I did in this program, I started in schools working with kids, was trying to create that linkage between joy and movement rather than punishment and movement, because I think it gets encoded so early that exercise is a form of castigation for not doing something right. And how will you ever do that by choice if you have that mental association? So I think that's really important to recognize and then unmake. 

DR. LUCY MCBRIDE: It makes so much sense. I completely agree with what you said earlier about exercise now being an obsession, but still thought to be a form of punishment. And right now we have industries around exercise like the peloton which has taken off, should have invested in the peloton, by the way, before the pandemic. 

NATALIA PETRZELA: Both of us. 

DR. LUCY MCBRIDE: Yeah. I mean, golly, you have like solid core, you have CrossFit, you have these exercise programs that are super popular, that are really, really intense, like the no pain, no gain model. And what I commonly see because I see a very educated patient population who are motivated to exercise, they are almost enslaved to their exercise routine, that they injure themselves, or they are so exhausted by the sleep deprivation that is required to get up, to go to this class, to then be told no pain, no gain, to then do it all over again. That I'm like, hold on a second. I think cycling is wonderful. I think core work is wonderful. In fact, if you could exercise, I recommend a combination of cardiovascular and core strength, right? That's the kind of Holy grail. But if you are using exercise as punishment and you are not so in control of your exercise routine, as your exercise routine is in control of you, then that is not necessarily healthy. Who am I to tell you what to do but just know that sleep also matters and that, like everything we can become obsessed with. Sometimes it's good to take stock of what our relationship is. 

NATALIA PETRZELA: Totally. And I think that that gets back to this holistic definition of health that we're talking about, right? Like if you are committed 100% to an exercise routine at the cost of sleep, mental wellness, perhaps repetitive use injuries, etc., that is not serving your overall health, even if you're like burning those calories or getting that training. And I think that is really so important to remember because it's often unacknowledged. Like I'm thinking of this wonderful opinion piece that came out a few months ago by this writer, Amie Neufeld, and she wrote a great memoir. I don't think this is in the memoir, but it was in her article. And she talks about how, like she had a really rough childhood and was engaged in all different kinds of kind of like self-harm and got therapy for it and moved past a lot of this. However, she channeled a lot of these energies into like intense over exercising. And one of the things that she commented with, which I thought was so spot on, is that whereas she had this great team that had spotted like all of these other problems that she was doing, cutting diet restriction, etc., when she was working out all the time, people kind of turned a blind eye because it was like, Oh, well, that's really healthy. You're going for a ten mile run and then yoga and then crew practice or whatever. And she talked about that I think so compellingly because I think quite often our exercise obsession in this country is the obsession with equating physical work with moral virtue, and that we are too ready to say, Oh, that's good for you. And not identify when it can be a real problem. And so the obsession, America's exercise obsession that I point out is, yes, the people who are so obsessed with their workout routines, they're like going way too hard for their health. But of course, let's look at the big picture. 80% of Americans are not even exercising close to the recommended minimums. But there's an obsession in many ways with pinpointing that as their moral failures. And I think both. 

DR. LUCY MCBRIDE: 100% both are problems. I mean, it's about balance. And not only do we equate exercise in this country with morality or virtue, you know, you see even the runways now are filled with people in jogging shoes and exercise clothes, which I totally love. By the way, let's 

acknowledge for a second that exercise is really important for people's mental health as well. And I think that's part of what you teach your students, right? Like it's important for mood, focus, concentration, managing stress. And again, this is like a tiny, tiny slice of the population, but people who are using exercise not even overusing it, but who are using exercise to help manage a mental health condition or just stress or trauma or whatever, they can accidentally put all their eggs in that basket. Perhaps like the woman who wrote that op ed did, at the expense of saying, you know what, exercise is not going to actually help me with these internal feelings of vulnerability and shame. In other words, just like Lipitor is to cholesterol, Exercise is not a cure for many things. Maybe I'm giving the opposite message. I'm just asking the question, I think of how can we untangle the relationship to exercise that we have that is rooted in morality, virtue, and then sometimes this mismanaged expectations of what it can do for us and then be more realistic and less shaming about it? 

NATALIA PETRZELA: Oh, it's so hard. If I had the answer to that, I'd have like Volume two and probably $8 Million, because I think we're all reckoning with this every day. And, you know, this question of like, what's the appropriate place of exercise in a kind of holistic health plan? Honestly, I think that it's very individual. Like there's this story that just sticks with me where, you know, so I teach fitness, as you mentioned, and I used to teach at Equinox. So they would like these huge classes. And the class that I teach, it's called intensity, and you're speaking affirmations while you are working out. You're like, I am strong, I am powerful. 

DR. LUCY MCBRIDE: I love like. 

NATALIA PETRZELA: It's like really great. 

DR. LUCY MCBRIDE: I'm calming, by the way. I'm signing. 

NATALIA PETRZELA: Up. Yes, Yes. I would love that any time. But I will never forget this. One time this woman came up to me after class and she says, like, I love your class so much, I stop going to therapy. 

DR. LUCY MCBRIDE: And that's what I mean. 

NATALIA PETRZELA: And part of me, of course, is flattered by that and just genuinely happy because it's nice to know that you're doing something that is really helping people feel happier. But on the other hand, I didn't know her. I don't know what her issues are. I know that a great workout with me is no substitute for the kind of clinical management of a whole host of things that people are dealing with. And so I was like, Thank you, you know, but maybe you should talk to your therapist before changing your program, you know? And so I think that that just speaks to the kind of difficulty in figuring out what the right mixture is. I do think if I had to make some sort of like population wide prescription, which is obviously an inherently flawed errand, I would say that like given how sedentary most of our population is, I think prioritizing moving more in your life is really important. And I say that with the full caveat that there's all kinds of access issues to who can do that and how they can do that. But I think that most people in the United States don't move very much. And I think that like movement is medicine goes like the quote you see on Instagram. Right. And I think that that can be true, but it needs a big Asterix that's like but not the only medicine that you might need. 

DR. LUCY MCBRIDE: Right. Exactly. It's not the only medicine. Then I would put another asterisk on it with the understanding that the vast majority of Americans don't even know how to go to the grocery store or they don't have time. And other asterisk is that it has to be realistic and sustainable for it to actually work. What would you say to someone who understandably is a single mom who's working and parenting and caregiving and who just doesn't have time, which represents so much of our country? I mean, for a long time, exercise has and still is thought of as a luxury. It's a luxury item. It's a specialty item. It's for people who have discretionary time. You know, it's one of the challenges I have with patients is, you know, some of my patients, I'm not going to say some. All of my patients are extremely busy. So to get someone to have a mindset shift is difficult and sometimes just not realistic. 

NATALIA PETRZELA: Sometimes it's not realistic. And there's a time for everything. People have different priorities and well, I think movement should be like pretty high on like most people's lists in some form or another. There are moments when that will wax and wane, and that's true for me too. And I'm like an exercise proselytizer. So I think that that's the first thing. The second thing is I do think that this time issue is really important. For everybody. I do think, obviously, like there's a big difference between someone who's extremely busy but has resources to spend on this and someone who's extremely busy and extremely strapped for money, for the person who's extremely busy and has resources, like there are a lot of options for you. Like, there's a lot of ways there are a lot of home fitness devices that you can buy because capitalism, you're going to be able to find someone to meet you at 4:00 in the morning to go running with you outside if you want to. Like there is a lot out there for people who can pay for it. And I don't mean to diminish the struggles of anyone to try and exercise. It can be really stressful for somebody who doesn't have money and doesn't have time. That is a lot harder. And in that case, I would say it is true. There is a lot of amazing free content on YouTube. On Instagram, it's a little harder to find it. But I would say starting with exercising at home, if you say like a single mom who has kids, if you can say, I'm going to wake up 20 minutes earlier than my kid and I'm going to put on some YouTube, it can be honestly could be an old YouTube Jane Fonda video. 

NATALIA PETRZELA: Like those are not bad. The movements haven't changed that much. The brands have. And you put that on and you do that for 20 minutes or 30 minutes, hold a plank, a few rounds of a minute each in between, go take a shower and then be with your kid. Like, that's enough. It really is. And something I feel very privileged to have resources to be able to do this. I am like, really busy. But one thing I've certainly learned as a mom, and it was heightened, of course, during COVID and remote learning and like all of that is like no opportunity is too small to do a little bit of exercise. And and that goes for writing too, by the way. But I think that that sensibility is so liberating from a lot of the dominant messaging that, like, if you can't go 60 minutes or 45 minutes, it's not worth that. Like that mentality. It was what has me be like, Oh, then forget it. And it's not like I'm even doing anything good with my 20 minutes. I'm like scrolling on the couch, doing whatever. So no opportunity is too small for meaningful exercise, I think is a really helpful way to think about that and also being very reasonable about what can and cannot fit into your schedule. Totally minutes at home before your kid wakes up is great. 

DR. LUCY MCBRIDE: The other thing is I love all of those. And then I would also add adding movement into your already existing life. So it sounds corny, but taking the stairs instead of the elevator, parking your car further away. You know, when you're talking on the phone to your sister every Tuesday night, also walk while you're talking and walk around your block. These things add up and they make a difference. It does not have to be perfectionistic. It does not have to be fancy. You don't have to be wearing designer leggings. You just have to move. And people often find that when they get into the habit of just moving more in their everyday lives, they feel better. And that's what matters. 

NATALIA PETRZELA: I agree. And I would add that another helpful tip in that regard, if this is your jam, is to kind of make it social like that really helps with accountability, you know, with like the really important thing that we're apparently losing in our culture based on recent studies, which is a loneliness epidemic, you said, and I am like the most gung ho exerciser, but I have this colleague who's become a friend and we meet most Wednesdays at like 550 in the morning to go to this bootcamp class. I have another girlfriend who I run with early in the morning and we like let go of speed. We're like, let's just talk like, let's make this like we're having coffee, but we're like jogging basically. Both of those things fill me up in ways that are so beyond the physical movement that we're doing, but I probably wouldn't be doing that physical movement if I didn't have the enticement of hanging out with my friend. And I think that cannot be said enough. It's really, really important and totally magical. 

DR. LUCY MCBRIDE: My women friends are like my chosen family and I think probably like you, they live in my heart and my soul. And so when I take a jog with my friend Courtney or take a morning walk with my friend Casey, or a hike with my friend Margaret, that is like the most magical time because it's like therapy, humor and movement all in one. It's actually quite efficient if you think about it that way. 

NATALIA PETRZELA: I totally agree. It is highly optimized, highly optimized. I do think the Zoom era and like, you know, for people who work from home, has kind of raised awareness of the power of that kind of interaction. My husband is like on Zoom 15 hours a day. I mean, it's crazy. And at the height of COVID and now he's more back in the office, but at the height of COVID, he was like, we could do walking meetings. You know, this is when people weren't really indoors and like that sort of remained right. And that's not exactly like a friendship meeting, but it's kind of bringing a little bit of energy, quite literally, into the doldrums of just staring at a screen all day. So I think the positive thing about the reorganization of a lot of our lives in the last few years is that we've had to think a lot more deliberately about how we move, why we move, what inspires us to what doesn't. Because the default for so many of us who are lucky to have been able to work from home is like total sedentary ness. So we have to be much more deliberate about that. 

DR. LUCY MCBRIDE: And let's go back to your point earlier about loneliness. I had the surgeon general on the podcast a couple of weeks ago talking about his work on social isolation, the importance of human connection, quite literally for our health. I mean, there's no shortage of data to show that loneliness has detrimental effects on our emotional health, our physical health, our cardiovascular health. I was so worried during the pandemic about children, which is why you and I met on Twitter, because children are future adults who went and traumatized show up in my office with myriad issues. I was also so worried about elderly folks who were isolated and alone and that potential harm to their health from the absence of social connection. It strikes me that your mission, your personhood, is about community building and that you are a community builder yourself. That you are correct me if I'm wrong, an extrovert. Are you an introvert? 

NATALIA PETRZELA: No. I'm like the most extrovert. I was going to say. 

DR. LUCY MCBRIDE: I thought you were. I thought you were saying you were introverted. I was like, That would like, mess up my paradigm of you. So it strikes me that you're an extrovert, that you're a community builder, that you are a community member. And so talk to me about your research and your current life vis a vis exercise as a vehicle for community building. 

NATALIA PETRZELA: You know, I'm a historian. I don't even know if we said that. So like not that kind of doctor that I'm looking at people's individual health profiles as you are or as like a medical researcher would be. But one of the things that was so striking in doing all this historical research over decades was that one of my guiding questions was why do people exercise? What makes them stick with it? What makes some brands or communities stick around for a long time? And perhaps it's obvious, but again and again it came back to community. Like the thing that gets people out in the world moving is so much of who they're doing it with. And this applies in across context, right? This is both like the kind of like L.A. glitzy health club in the eighties that had everyone in leotards doing aerobics. And it was like, see and be seen kind of like singles club. It is the running club in Harlem where, you know, a group of like minded people get together and take to the streets. I mean, I have one example after another of this. And to me, like that's often not talked about because we discuss exercise is such a kind of individualistic health pursuit, right? Like the community is just like icing on the cake. 

NATALIA PETRZELA: You're really there just for your own health outcomes. I really discovered through that research, but then just through the lived experience of the pandemic and stripping away all of those group environments, that community is not just some secondary effect. It's actually a primary health creating, boosting aspect of exercise. And I know there are a lot of like solo exercisers who love that. And during the pandemic they got their peloton. They're never going back. They're like, The gym is disgusting, that's fine. But I think that exercise is the realm that I look at, and I think that it is very clear that human connection is extremely powerful and in the realm of exercise, it can motivate you to exercise more and it can just like enhance all of your other gains in a really powerful way. So, you know, I'm not like forcing anyone to go get into a group fitness class. I know for some people that's like, complete hell, you should exercise how is right for you. But I do think the community piece of whatever you're doing is pretty integral and that we really ignore that at our peril because doing things remotely or on your own can feel so efficient. But I think in that obsession with efficiency, a lot is lost. 

DR. LUCY MCBRIDE: Absolutely. I have a patient I saw a couple of weeks ago who lost her husband during the pandemic and was so lonely and so isolated and of course, grieving through the pandemic. And she had never been an exerciser. And so she and I talked about her grief and her health in general, of course. And I suggested she join a group exercise class to kind of connect with other people, get her body moving. And she at first was like, oh, my gosh, you've got to be kidding me. Doesn't every doctor recommend yoga? Doesn't every doctor recommend exercise? I'm like, Yes. And let's see. So she ended up joining this class for older women with osteoporosis, and it's yoga. And Pilates is kind of a mix. And she's like, come alive. It's so beautiful. I mean, she's still grieving, of course, but it has served so many different purposes for her health and wellbeing. 

NATALIA PETRZELA: There are million stories like that. I'm so glad to hear of her. And it's like it's so funny. It just feels so obvious in a lot of ways. But I think when you're in that moment, especially if that's not your sort of natural inclination, it feels like the opposite of obvious. It's like, I can't imagine myself being one of those people. One of the positive developments, I would say in like exercise culture in America, though, has been the sort of like multiplicity of options that exist, like when you talk about the fact that your patient could just like find a Pilates yoga fusion class for women with osteoporosis like that is a relatively recent development. I mean, it's a long time ago in like normal people's counting, but not that long ago for men. Historian's counting. But like, you know, in the 1990s, you still heard again and again like, well, I have to be fit before I go to the gym because gyms are places where fat people hang out. And of course there's still definitely environments like that. I'm sure we've been in them ourselves where unless you look like a size zero in the perfect clothes you like feel like an outcast. But the dominant movement of the industry is not like that. Like now, you know, there are all kinds of offerings for older people, for people with different kind of health issues or health profiles, I should just say, not even issues and preferences. And I think that's a really positive development. 

DR. LUCY MCBRIDE: Yeah, And we talk about equity. I mean, that's what matters too. It's about accessibility, but it's also about seeing yourself in some of the people at the gym. I mean, if you are going to a gym and no one looks like you in any way, shape or form, that's a barrier. 

NATALIA PETRZELA: Oh, totally. I mean, this is a huge theme in my book. And someone asked me in another interview like what was one of the most surprising or cool stories that you learned. And one of the things that I learned about was this incredible movement, no pun intended, in the 1980s of fat aerobics. And there were all these women who, like, wanted to get in on the trend, felt like none of the instructors looked like them. They had certain, like different ways that they moved. And these two women, they wanted to hire instructors who looked like them. There was like no certified fat instructors. So they put their studio plans on hold, They go get certified, they end up opening this gym and it becomes a franchise not as big as what you might have heard of, but like this fat aerobics movement totally reflects the fact of like being able to walk into a space and feel like you belong there in the most basic visual way is really important. 

DR. LUCY MCBRIDE: Absolutely. So, Natalia, let's talk a bit about you. The tentative title of my upcoming book is called Are You Okay With the Frame of It? Meaning not. This is an accusation of a question. It's a empathetic question. Are you okay? I mean, it means that we assume that we're not okay in every way because who is So I guess I'd ask you that. Like, are you okay? 

NATALIA PETRZELA: I think I'm okay. I feel pretty good. I mean, in terms of all of the, like, big picture things in life, I feel very fortunate. I mean, it's probably a terrible idea to list all those ways. But, you know, I'm like in generally good bodily health. I have a great family. You know, I'm so proud that this book that I thought I'd never finish because of the pandemic, it's getting out into the world and gainfully employed. Like, I feel good. So, yes, I am. Okay. That being said, I think it's interesting that question, because I certainly like want to be more than okay. And I think that in certain really good ways, we have this bar of thriving, not just surviving, that we hold up. And I definitely hold myself to that because I think every day that I'm alive, it's an absolute gift. But on the other hand, sometimes I'm like, maybe I don't need to, like, thrive every day. Maybe like, okay is enough. And I should be grateful for that too. 

DR. LUCY MCBRIDE: To me, the the goal of health is to be a little more okay tomorrow than we are today, but also to be okay that we're not okay. In other words, it's all relative. It's mental, it's physical, it's spiritual, it's cultural. And so I guess what I would ask you next is what would you like in your life starting today to be more okay. Would you like more hours in the day? Would you like to do more exercise? Would you like to do less exercise? Get more sleep? Do you need to have a body double to do all the podcasts and promotion for this new incredible book?

NATALIA PETRZELA: So if I could have one thing, I would probably want more hours in the day because there's just so much life to live. And I mean that professionally. Personally, I just want it all and there just aren't enough hours in the day to do that. But to put a finer point on it, I think it's a more interesting answer. I will say that there are two areas of my life that I'm like, I'd love to be a little more. Okay. And and one is, you know, I have these wonderful friendships that I've had. Some are like friends I've been friends with since five years old. I just have felt that the coincidence like coincidence of having children, like basically all of us and really having a career that I take very seriously means that there isn't sort of naturally a space in my life where I can really cultivate those relationships. And I feel lucky that those friendships are so deep that like we pick up where we left off, like all the time. But I also fear sometimes you can take that for granted and that like if you don't do the work of maintaining those friendships, they can wither. And so I do think about that a lot because I think that we have a sort of cultural script and set of expectations that like, you know, you invest yourself fully in your job, your spouse, your children. Like there's like cultural room for all of that, but space for friendships for their own sake, not the people who you see on the sidelines of your kid's games or who you have sort of happenstance relationship. I love those people too, and I value them. But space for friendship, for friendship sake, that is hard. And I really think often about how that's an area where I would love to be able to invest more fully. 

DR. LUCY MCBRIDE: I think it's so important that you know that about yourself and that you love those friendships. And again, it's a matter of just having more hours in the day. I am like you. I'm trying to suck the juice out of life and I'm so grateful for every day and really, really value time with my family, my friends, time to sleep and exercise and just stare at the wall. The idea I had as you were talking because I'm always thinking of ideas. We someday run a retreat where you bring your people. I bring my people and you have a central meeting place where you talk about relationship with food, relationship to exercise health wellbeing in a more nuanced way, and drink some wine, have some fun, have some laughs at the same time. Just an idea. This is all stuff I think about in the shower all day long. I think about book chapter titles, I think about newsletter titles. I think about what I'm going to write next for The Atlantic anyway. I'm just throwing it out there. 

NATALIA PETRZELA: I love that idea. It happened here, our listeners. I love that idea. Yeah, I think that would be so great. And it's funny that you mention a retreat because I have exactly once in my life gone on a retreat. It was 2007. It was right before I got married. It was like a big, like sort of gift to myself. And it sounds so glorious to, like, be able to facilitate something like that, but also to even, like, be able to participate in something like that. So now, like you said it like from your lips to God's ears or whatever, it just doesn't make. 

DR. LUCY MCBRIDE: It happen to smoke. And who knows? I mean, if you don't dream it, it will not happen. 

NATALIA PETRZELA: I totally agree. I think that would be so great. And I don't think that I'm alone in craving that sort of space for reflection. And I also think back to our earlier point in our conversation. These deliberate spaces for in person kind of collective community are just really wonderful and special, you know, not to mention travel. 

DR. LUCY MCBRIDE: So and there's so much wisdom from everyday people who don't have a PhD or an MD and they I mean, that's one of my favorite parts of my job is I learned from my patients as much as I hope they learn from me, and that helps me kind of sculpt my. Doing even better. So I don't know. It's an idea. Let's end with this. What is your hope with this book? What do you hope it's going to do for people? Who do you want it to touch? 

NATALIA PETRZELA: Yeah, So it's interesting. One of the main arguments of the book we didn't really touch on here, but, you know, a big overarching argument is that we've become a nation sort of obsessed with exercise and invest in great sort of moral assumptions and people who exercise. But at the same time, we have created a situation where exercise is almost exclusively available on a private market. Right. If you can pay to participate. Okay, fine. If not, we'll judge you for it. And we will not create good physical education, invest in public recreation facilities, have well-lit safe streets and tennis courts and running tracks and all the rest. So who do I hope reads this? I hope that everybody reads it and buys it, But I hope that everyday people read this and reflect on why they do or don't move. But then on a kind of macro level, I hope that policymakers read this and think about what does it take to actually create a healthy society where people have access to exercise and to exercise on their own terms, not just people who can pay to have that as a privilege rather than a right. 

DR. LUCY MCBRIDE: And then make that a double on health care and then we're good to go. NATALIA PETRZELA: Yes, absolutely. 

DR. LUCY MCBRIDE: So I really hope that your message is resonating with policymakers, because I know it's resonating with readers. I've had the chance to read some of it, not all of it, I'll admit. And it is so amazing and you're such a good writer and it's clear that you spent a decade because it's very, very detailed and thoughtful and beautifully written. 

NATALIA PETRZELA: That means the world. I'm at that place right now. I'm sure you can empathize where you work on something for so long and you're both so excited it's out in the world, but also like kind of terrified. Like I'm like, I can't change it. I hope people like it. So smart readers like you finding it valuable, that means the world to me. Thank you. 

DR. LUCY MCBRIDE: Natalia, thank you so much for joining me today. It's been a pleasure talking to you. 

NATALIA PETRZELA: Likewise. I'm so happy to be on here and I can't wait for more collaboration. 

DR. LUCY MCBRIDE: Thank you all for listening. To Beyond the Prescription. Please don't forget to subscribe. Like download and share the show on Apple Podcasts, Spotify, or wherever you catch your podcasts. I'd be thrilled if you like this episode to rate and review it. And if you have a comment or question, please drop us a line at info at Lucy McBride. The views expressed on the show are entirely my own and do not constitute medical advice for individuals that should be obtained from your personal physician. Beyond the prescription is produced at Podville Media in Washington, DC. 

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Each week, Dr. Lucy McBride talks with her guests like she does her patients — pulling the curtain back on what it means to be healthy, connecting the dots between mental and physical health. To Dr. McBride, health is about more than the absence of disease. Health is a process, not an outcome. It's about having awareness of our medical facts, acceptance of the things we cannot control, and agency over what we can change. To learn more about Dr. McBride, visit: https://www.lucymcbride.substack.com/about To sign up for her weekly newsletter, visit www.lucymcbride.substack.com/welcome