Highlights
- •Physical activity and exercise help with loss in weight, body fat and visceral fat.
- •The effect on weight loss as outcome is relatively modest (a few kg).
- •Improvement in fitness (aerobic capacity, muscle strength) is important for health.
- •Prescription will depend on goals tailored for each patient to make progress.
- •Solutions should be proposed to patients to overcome barriers to physical activity.
Abstract
Physical activity and exercise have many benefits in persons with obesity, helping
with weight loss, body fat loss, abdominal visceral fat loss and possibly with weight
maintenance after weight loss. The effect of exercise training (endurance or endurance
plus resistance or high-intensity interval training) alone on weight loss as outcome
appears relatively modest, amounting to only a few kg. However, endurance training
during weight loss has been shown to increase V̇O2max and resistance training during weight loss leads to lower loss in lean body mass
and increased muscle strength. In addition, higher physical activity levels improve
cardiovascular risk, whatever weight variations. Specifically, physical activity or
exercise is part of lifestyle measures for prevention of type 2 diabetes and substantially
helps with metabolic control in patients with type 2 diabetes. The importance of physical
activity counselling and exercise prescription in the management strategy will depend
on specific treatment objectives as defined for a given patient, including weight
loss, prevention of weigh regain, prevention of cardio-metabolic comorbidities, lean
body mass preservation but also improvement in quality of life or development of social
links. The 5 A's strategy consisting in: Ask, Assess, Advise, Agree, Assist (or Arrange)
appears well adapted in this setting. Professionals need to be aware of the many barriers
patients with obesity may meet on their way to increase habitual physical activity
as specific solutions should be proposed. A major challenge is how to improve adherence
to new physical activity habits over time.
Keywords
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Article info
Publication history
Published online: May 21, 2021
Accepted:
April 28,
2021
Received in revised form:
April 20,
2021
Received:
October 30,
2020
Footnotes
Special Issue on Obesity - Guest Editors Profs D. Dicker and L. Busetto
Identification
Copyright
© 2021 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
