Exercise and Obesity

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Obesity and overweight are linked to a wide range of medical conditions, such as hypertension, diabetes mellitus, osteoarthritis, obstructive sleep apnea, and coronary artery disease. Overweight and obese patients who are unable to lose weight with diet alone can benefit from well-structured exercise. Potentially, an individual exercise prescription can become one of the most important components of an obesity treatment program, along with an appropriate diet. Short-term (<6 months of duration) interventions consisting of exercise combined with appropriate diet and counseling can produce a significant weight loss. No consensus exists on the amount of physical activity necessary to maintain the weight loss achieved during a short-term intervention. Long-term intervention is frequently influenced by weight regain related to complex interactions between physiologic and psychosocial factors.

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Comorbidities of overweight and obesity

Overweight and obesity are associated with numerous chronic conditions including hypertension, type 2 diabetes mellitus, and coronary artery disease.3 Type 2 diabetes is strongly associated with overweight and obesity predisposing to insulin resistance. Association between excess body weight (BW)/obesity and fitness level in individuals with type 2 diabetes is presented in Fig. 1.

Hypertension in obese patients is more prevalent than it is in the general population. The association between

Benefits of exercise in overweight and obese patients

Exercise is one of the most important components of the overall approach to treating obesity. When performed regularly and properly, exercise has a powerful protective effect against obesity comorbidities. Physical activity not only contributes to an increased energy expenditure and fat loss but also protects against the loss of lean body mass, improves cardiorespiratory fitness, reduces obesity-related cardiometabolic health risks, and evokes sensations of well-being (Box 1).11 Therefore,

Short-Term Interventions (6 Months or Less)

Exercise has become one of the most important components of the overall approach to treating obesity; however, conflicting data on the efficacy of exercise compared with that of other interventions exist. Common features of weight reduction programs incorporating exercise into long- and short-term interventions find clinically significant benefits immediately after implementation and continued benefit for up to 1 year.17, 18 Little is known about the predominant goals, methods, and durations of

Physical activity in the treatment of obesity

Using epidemiologic, clinical, and laboratory methods, different expert committees (NHLBI Obesity Education Initiative Expert Panel on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults; US Preventive Services Task Force; American College of Sports Medicine [ACSM]; Council on Sports Medicine and Fitness; Council of School Health; US Department of Health and Human Services; and US Department of Agriculture)3, 29, 35, 36, 37, 38 have independently arrived at similar

Exercise and the geriatric population

The relationship between an individual's weight, health, and age is not clear. Studies of all-cause mortality have shown different, and sometimes conflicting, evidence when relating weight to age. Weight loss in older individuals may be associated with an increase in all-cause mortality as well as other negative effects. So how should physicians advise their patients regarding weight and exercise as they age? Most physicians and patients agree that maintaining a healthful BW and level of

Exercise and obesity in children

The prevalence of childhood obesity is increasing in both developed and developing countries. Children and adolescents are less physically active today than were those of previous generations. The vast majority of obese children will grow up to be obese adults.36 There is a similar set of comorbidities associated with obesity in the pediatric population as those associated with obesity in adults.37 In addition, there can be consequences to still-developing bones and joints, such as slipped

Future research directions

Because of the paucity of consistent, high-level evidence with regard to treatment of obesity, particularly with physical activity interventions, further research is needed to develop an optimal, evidence-based approach to treat obesity. To help in this development, future research should focus on the following: treatment of obesity with special attention to long-term interventions and causes and mechanisms of overweight and obesity in relation to physical activity, abdominal fat, BW, and risk

Summary

Physical activity is a key component in maintaining fitness throughout a person's life. Exercise has a protective effect against obesity-related comorbidities even if weight loss is not obtained. Interventions for weight loss have shown minimal effect on weight but do improve overall health in children, adolescents, and adults. More studies are needed to determine an optimal evidence-based approach to the treatment of obesity. No consensus exists on the amount of exercise needed but, at this

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