IF YOU ARE MARKEDLY OBESE
The more overweight you are, the harder it will be to exercise. At some point even light exercise becomes impossible. Average-height women tipping the scales at about 280 pounds (127 kg) and men at 360 pounds (164 kg) aren’t going to be able to jog around the block, much less run a marathon. These weights are 100 percent over ideal or healthy levels. An actual “exercise program” probably won’t be possible until some weight is lost simply through very-low-carb eating, calorie restriction, or bariatric surgery. The initial exercise goal for you may just be to get moving through activities of daily living and perhaps brief walks and calisthenics while sitting in a chair.
Markedly obese people who aren’t up to the aforementioned extreme weights can usually tolerate a low-intensity physical activity program. At 50 percent over ideal weight, an average-height woman of 210 pounds (95 kg) is carrying 70 excess pounds (32 kg) of fat. Her male counter-part lugs around 90 pounds (41 kg) of unnecessary fat. This weight burden causes dramatic breathlessness and fatigue upon exertion, and makes the joints and muscles more susceptible to aching and injury. If you’re skinny, just imagine trying to walk or run a mile carrying a standard five-gallon (19 liter) water cooler bottle, which weighs only 43 pounds (19.5 kg) when full. The burden of excess fat makes it quite difficult to exercise.
If you’re markedly obese, several tricks will enhance your exercise success. I want you to avoid injury, frustration, and burn out. Start with light activity for only 10 or 15 minutes, gradually increase session length (e.g., by two to four minutes every two to four weeks) and increase exercise intensity only after several months. Your joints and muscles may appreciate easy, low-impact exercises such as stationary cycling, walking, swimming, and pool calisthenics/water aerobics. You may also benefit from the advice of a personal fitness trainer arranged through a health club, gym, or YMCA/YWCA. Check out several health clubs before you join. Some of them are primarily meat markets for beautiful slender yuppies. You may feel more comfortable in a gym that welcomes and caters to overweight people. Hospitals are increasingly developing fitness centers with obese orthopedic, heart, and diabetic patients in mind.
Paleo Diabetic 
I found this to be true in my journey. At 237.5 I was unable to exercise. I sat on the couch and did curls with canned vegetables and used some stable bike pedals while sitting. Changing what I was consuming to low carb enabled me to lose about 30 pounds which enabled me to add exercise to my life.
Having been heavy most of my life, just being able to exercise gave me a sense of pride like no other. Because of this not many days pass without exercise.
Thank you for your post. Most people (my doc included) would tell me to just exercise and I would lose weight, they never even thought about how I was too big to “just exercise”.
mj9706, thanks for your testimonial. You may have just convinced someone to try your method, and they’re likely to be better off for it.
-Steve
a few years back I attended a talk given by James Levine, a guy who regularly works with morbidly obese patients. He said some of the early goals are walking for 1 – 5 minutes. Gotta start somewhere. (he is also currently promoting treadmill-desks for cubicle-bound employees http://www.ncbi.nlm.nih.gov/pubmed/23417995)
Bill, thanks for the link.
I weight currently about 110 kilograms, I have been very close to 120 at times, my height is a bit under 160 cm, and I do make 4 to 6 kilometer walks rather regularly during the summer. I also work as a morning paper deliverer, and while now I have an easy route I do mostly by car I still do have a couple of apartment buildings with no elevator (four floors, just two staircases), and four years ago was doing three three story buildings with 10 separate staircases (okay, I’m not a native English speaker, I think those may have some name). Took me about half an hour, and I was able to do about half at a half run before I had to go back to walking and I did weight the same or a bit over what I do now.
So even with lots of excess weight you can get into a good enough shape to do exercise, if you just keep doing it on a regular basis.
By the way, I have always been overweight, and I have never managed to lose weight by exercising. I have been in a damn good shape at times, possibly with a nice set of muscles with unfortunately nobody could see as they always were under a thick layer of fat. I didn’t even lose weight in my 20’s when I did geological mapping as a summer assistant in areas well away from any roads, we lived up to 3 months in tents, went to get supplies about twice a month, I was trying to diet so always bought with that in mind (problem may have been that was the 80’s, so that diet was somewhat rice and pasta heavy, and most of the other stuff as low fat as I could find), and walked up to 20 – 25 kilometers most days in forest which had no paths. Some summers I lost no weight. A few times up to about 5 or 6 kilograms, but unfortunately I was then already about 30 kilos overweight, and I also usually gained it all back, with a little bit extra, during the next winter (seasonal affective disorder – I have never eaten much, or regularly, of the usual trash foods, but I used to eat lots of stuff like potatoes and that pasta during the winter, and now that’s the time of the year I do fall for them, well, not pasta since anything wheat now gives me the runs, but rice and potatoes and such, yes, I don’t eat them during the summer but I can’t completely resist them during the winter).