I want to exercise, but I’m so fatigued that I can’t get off the couch. Help, please!

    —Too Pooped

Ah,fatigue—that annoying yet faithful mate of HIV. From the virus itself,the meds, depression, hepatitis or poor diet and lost sleep, it gets acapital “P” for problematic (and pooped).

See if your doctorcan find a cause—and treatment—for your fatigue. But in any case,movement can alleviate depression, stress and fatigue itself, whilebuilding resilience. Some tips:
  • Begin by awakening body and spiritwith a few minutes of quiet meditation. Tell yourself it’s a new dayand that you can move and act.
  • Start with a breakfast of carbs, likepancakes or cereal with bananas, for energy. Plan a simple activity youenjoy, such as walking or bike riding. Begin slowly, at a steady pace,to manage your energy. Listen to your body, stop when needed, sit downto recover, note how long you exercised—and be proud.
  • Now set ashort-term goal such as walking or biking for a set amount of timeevery day. After a while, you can add more time or distance or otheractivities.
I speak from experience: I spent 1997 to '98 at home on a feeding tube.  Thankful I was alive and knowing I was worth the effort, I would get out bed and take a walk.  I know you have the spirit and determination to succeed, too.

I’ve beendoing the same fitness routine for almost as long as I’ve had HIV. Whyhave I stopped seeing improvements—especially in my abdomen?  
                              – Ab Flab

It’s great that you’ve been working outto trim HIV-related woes, from elevated blood fats to weakenedimmunity. But you need to challenge your muscles by switching yourroutine every three to four months. Include a different ab routine ineach workout session, 25 reps per set, resting one minute per set. Keepyour core tight during all your upper and lower body exercises—lose thecontraction and you lose the effect. Do this in everyday life, too.Walking down the street, tuck and contract your abs to improve yourposture and strength.

If it’s lipo’s deep fat beefing up yourbelly, try weight lifting. Even without studies, it’s pretty safe tosay that consistent weight lifting can help your body produce moregrowth hormone and testosterone (and the amino acids that help yourbody use it). It also boosts insulin sensitivity, helping your bodyprocess and use sugar (and avoid lipo).

Jeffrey Gross is a certified fitness trainer in Chicago.

Got a question for our trainer? E-mail it to trainer@poz.com.