MEDICAL CONDITIONS: OBESITY :
PHYSICAL EXERCISE AND FITNESS:
Exercise Aspects of Obesity Treatment
Exercise Aspects of Obesity Treatment
Matthew A. McQueen, MD
Ochsner J. 2009 Fall; 9(3): 140143.
The Ochsner Journal
PMC (PUBMED CENTRAL)
The negative effect of obesity is significant in terms of U.S. health care dollars spent, totaling some $100 billion annually, or 5% to 10% of U.S. health care dollars.1 An estimated 55% to 60% of adult Americans are overweight, defined as a body mass index (calculated as weight in kilograms divided by height in meters squared) of 25 to 29.99, and 22% more adults are obese, defined as a body mass index exceeding 30 kg/m2. The prevalence of obesity is increasing. Weight loss reduces the comorbid disease risks associated with obesity, such as diabetes mellitus, hypertension, cancer, hyperlipidemia, and heart disease.
Weight loss is a process that includes a reduction of caloric dietary intake and an increase in physical activity-related caloric output. This article will review some established guidelines concerning exercise treatment of obesity. A discussion of the dietary component is beyond the scope of this review, but a significant overall reduction in daily total caloric intake should be the main focus rather than macronutrient composition. Reduction of dietary fat intake to less than 30% of total energy intake as part of this overall reduction may also facilitate weight loss.1 A calorie reduction diet coupled with an exercise program has been shown to be superior to an exercise intervention alone.1,2
The process begins with an assessment of the obese patient for safety before entering an exercise program. The accepted amounts, type, and progression of exercise for healthy individuals are reviewed and are then discussed more specifically for obese patients. Obesity comorbidities such as osteoarthritis and metabolic and cardiovascular disease should be addressed in the exercise recommendations. Psychosocial barriers to an exercise program must likewise be addressed. Finally, maintenance of a healthy ongoing exercise program is vital in preventing weight regain.
Topics Covered in This Artcile:
OBESITY FITNESS GUIDELINES
Obesity is a complex malrelationship between energy intake and expenditure that results in a homeostasis that is resistant to change. Obesity clearly has negative health implications that are well documented in consensus literature. Likewise, correction of body weight reduces the incidence and severity of comorbid diseases. A key aspect to this end is a significant amount of physical activity that is appropriately supervised and quantified. The objective of this review was not so much to explore the intricate physiologic details of the treatment of obesity but rather to provide an overview of the preparticipation assessment and practical application of an exercise program for the treatment of obese patients. Many physicians never broach this subject with their patients because of time limitations or comfort-level constraints. This is unfortunate because a physician’s recommendations and proper guidance at the point of care are important predictors of patient participation in exercise.5
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Link to and Results of
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