Physical Activity For The Treatment Of Obesity

The modern environment in which we live is “obesogenic”, i.e. promotes weight gain and obesity. People move less and less and waste hours a day commuting long distances by car or public transport in busy schedules and spending a lot of time sitting at work. After an exhausting and stressful day, it is difficult to be motivated to exercise.

In fact, physical activity is very valuable because it supports metabolic, cardiac, and respiratory function regardless of weight. It is of primary importance in preventing obesity and maintaining a normal weight, but it could also support the weight loss process.

The recommended rate of weight loss is 0.5 to 1 kilogram per week. This can be achieved by maintaining a negative energy balance of around 500-1000 kcal per day for a long period of time. However, only a change in dietary regime will hardly achieve this level. A drastic reduction in caloric intake leads to a loss of muscle mass and a corresponding slowdown in metabolism, which is the basis of the yo-yo effect after diets.

On the other hand,  achieving such a caloric deficit with physical activity alone is extremely exhausting. This equates to about 60 minutes of moderate to high-intensity exercise 7 days a week. There are few people who would withstand such a load for a long time.

That is why it is necessary to combine a diet with increased physical activity. In this way, a change in body composition is promoted with the loss of mainly fatty tissue and the preservation of muscle mass, which is important for maintaining the basic metabolism. This is why people who combine a hypocaloric diet with exercise are much more successful in losing weight and keeping it off.

According to the recommendations of the World Health Organization (WHO), all adults (between 18 and 64 years) should have regular physical activity of at least 150-300 min of moderate-intensity exercise or 75-150 min of high-intensity training per week. In the absence of contraindications, one can increase the duration of physical activity to obtain additional health benefits. Also, muscle-strengthening workouts that target all major muscle groups on two or more days of the week are recommended.

Attention is also paid to sitting time, which should be limited and replaced with movement of any intensity (including light-intensity activities).

In addition to maintaining weight, physical activity reduces total and cardiovascular mortality, the incidence of hypertension, diabetes mellitus, and some cancers, and improves mental and cognitive health, and sleep quality. In older people (over 65 years) and those with chronic diseases and disabilities, physical activity further prevents falls and improves bone health. Balance and muscle strength exercises are recommended for this group at least 3 days a week.

Physical activity in pregnancy reduces the risk of pre-eclampsia, high blood pressure, gestational diabetes, excessive weight gain during pregnancy, birth complications, and postpartum depression. At least 150 minutes of moderate-intensity activity per week is recommended, and women who routinely engage in high-intensity exercise before pregnancy can continue during pregnancy and postpartum. Light stretching can also be included.

Some physical activity is better than none! Even if the specified duration and intensity are not achieved, any movement has health benefits. It is recommended to start with small loads and gradually increase the frequency, intensity, and duration. Older people should adapt physical activity to their functional capabilities.

Physical activity does not mean only structured training with a certain number of exercises for a given period of time. Movement in any form is included, such as walking, climbing stairs, housework, and dancing.

It is established that the accumulated energy expenditure during the day is a major predictor of weight loss in obesity. This means that both a 30-minute workout and several 5-10-minute periods of increased movement will have a similar effect on weight. Another goal that is often set is to reach 10,000 steps during the day, regardless of the intensity and time for which it will be achieved.

1. Bull, F., Al-Ansari, SS, Biddle, S., Borodulin, K., Buman, MP, Cardon, G., et al. World Health Organization 2020 guidelines on physical activity and sedentary behavior. Bro. J. Sports Med. 2020,54:1451-62.
2. Stone T, DiPietro L, Stachenfeld NS. Exercise treatment of obesity. Endotext [Internet], 2021 May 15

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