EXERCISE AND WEIGHT LOSS

Physical activity can improve the health of overweight and obese people. Structured exercise has the benefits of improving physical fitness, flexibility, mobility, and cardiovascular health. Specifically, common problems of this population such as hypertension, type 2 diabetes, dyslipidaemia, blood pressure and Framingham risk among others will be improved. To realize the importance of exercise, obese people with good cardiorespiratory fitness have lower cardiovascular risk than unfit normalweight people.

It will also increase energy expenditure mobilizing and burning stored fat. Exercise combined with calorie restriction will result in weight loss, which is necessary in this population. Regarding the type of exercise, the most effective programs in weight loss are those that combine aerobic and anaerobic endurance and resistance training. However, a complete physical activity program should incorporate balance and flexibility exercises with the goal of prevent injuries. 

There are basic items that you must follow:

Aerobic exercise

It should be the foundation of exercise for obese people.  Vary the routine to reduce injuries from overuse.

• Frequency: 5 or 6 days per week
• Intensity: low to moderate (being able to carry on a conversation)
• Duration: 150 to 300 minutes per week
• Type: walking, riding a stationary bicycle, swimming or aqua-aerobics

Published by Higgins et al. (2016)

High-intensity interval training (HIIT)

HIIT involves relatively brief bursts of vigorous exercise separated by periods of recovery. Many investigations suggest that HIIT can achieve similar health adaptations and calories burned to those of continuous exercise, despite the fact that less time is spent.

However, to reach high intensities during exercise may be dangerous for untrained people and can also result in musculoskeletal injuries in obese individuals, so we must be careful. We must be sure that the HIIT does not involve any danger before starting exercising.

• Frequency: 3 days per week
• Intensity: high
• Duration: 20 minutes a day, 75 minutes a week

Progressive resistance exercise

This activity is generally easier and allows obese patients to exercise around people who can motivate them. The result is improved muscular strength, socialization, and increased confidence in their abilities.

• Frequency: 2 or 3 nonconsecutive days a week
• Volume: 8 - 10 exercises, 2 - 4 sets of 8 - 12 repetitions
• Intensity: progressive, to prevent injuries
• Type: exercises that mobilise large muscle groups

Published by Higgins et al. (2016) 

Flexibility and balance

These types of exercises will not be used for caloric expenditure. The aim of the flexibility training will be to increase or maintain joint range of motion. It will also be able to improve muscle and joint pain associated with obesity.

• Frequency: 2 - 4 days per week
• Duration: hold each position for at least 15 seconds
• Intensity: do not fell pain but a little strain
• Warm-up before stretching

Balance helps obese people to improve their stability. Poor balance is associated with falls, accidents and injuries. Equipment is not necessary, balancing on one foot for 15 seconds and standing up and sitting down without using the hands are examples of stability training

• Frequency: 3 days a week
• Duration: 10 minutes a day

Published by Higgins et al. (2016)

Be careful prescribing exercise for overweight and obese people and consult a specialist in sports science before starting a physical activity program.

More information about this topic in the following paper:

Higgins, J. P., & Higgins, C. L. (2016). Prescribing exercise to help your patients lose weight. Cleveland Clinic Journal of Medicine, 83(2), 141–150. https://doi.org/10.3949/ccjm.83a.14139

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