Review article
Exercise in the treatment of obesity

https://doi.org/10.1016/S0889-8529(03)00075-6Get rights and content

Section snippets

Pre-exercise evaluation of overweight patients

Many physicians and health care providers are responsible for the medical care of overweight and obese patients. Before recommending an exercise program for these individuals, the clinician may need to consider several factors that could impact the safety of the patient and the effectiveness of the recommendation.

How much exercise is enough?

The prescription of exercise for overweight and obese adults should take into consideration the desired outcome for including exercise in obesity prevention and treatment programs. It seems that numerous goals may exist, and the importance of these goals may vary based on the perspective of the clinician and patient. For example, the ultimate goal of prevention and treatment programs is to improve the health of the patient. From one perspective, this may involve the medical management of risk

Facilitating adoption and adherence to the exercise prescription

Similar to other health-related treatment prescriptions, the exercise that is prescribed will only be effective if patients adhere to the desired treatment plan, and if the desired treatment plan is consistent with the desired health-related outcomes. For example, the clinician may prescribe an exercise program for obese patients that, if implemented, should be very effective in eliciting the desired outcomes. Patients may have difficulty implementing and adhering to this exercise prescription,

Summary

Exercise is an important component of behavioral weight control interventions, and exercise may be most effective for weight control when combined with modifications to energy intake. Clinicians should initially encourage overweight and obese adults to adopt at least 150 minutes of moderate-intensity exercise per week (30 min×5 d/wk), because this level of exercise has been shown to improve health-related outcomes. Higher levels of exercise, however, may be necessary to enhance long-term weight

First page preview

First page preview
Click to open first page preview

References (34)

  • American College of Sports Medicine

    Guidelines for exercise testing and prescription

    (2000)
  • B.H. Marcus et al.

    Self-efficacy and the stages of exercise behavior change

    Res Q Exerc Sport

    (1992)
  • B.H. Marcus et al.

    Efficacy of an individualized, motivationally-tailored physical activity intervention

    Ann Behav Med

    (1998)
  • B.H. Marcus et al.

    Evaluation of motivationally-tailored versus standard self-help physical activity interventions at the workplace

    Am J Health Promot

    (1998)
  • R.R. Pate et al.

    Physical activity and public health: a recommendation from the Centers for Disease and Prevention and the American College of Sports Medicine

    JAMA

    (1995)
  • J.M. Jakicic et al.

    American College of Sports Medicine position stand: appropriate intervention strategies for weight loss and prevention of weight regain for adults

    Med Sci Sports Exerc

    (2001)
  • Institute of Medicine

    Dietary reference intakes for energy, carbohydrates, fiber, fat, protein and amino acids (macronutrients)

    (2002)
  • Cited by (73)

    • Appetite Regulation and Thermogenesis

      2015, Endocrinology: Adult and Pediatric
    • The midwest exercise trial for the prevention of weight regain: MET POWeR

      2013, Contemporary Clinical Trials
      Citation Excerpt :

      The HHS guidelines, although not specific to weight management have been interpreted to be sufficient for that purpose. Support for these recommendations is tenuous and is derived from studies with important limitations including: 1) cross-sectional, non-randomized observational designs [2,15,28–33], randomization prior to weight loss: secondary analyses of exercise groups formed at study completion [34–36], self-reported levels of exercise [28,36,37,38]; and 5) failure to supervise exercise and verify level of EEEx [36–38]. Three organizations offering exercise recommendations for the prevention of weight regain (HHS, IOM, ACSM) have highlighted the need to conduct adequately powered studies of sufficient duration, with randomization to different levels of exercise following completion of weight loss to address the issue of the amount of exercise required to minimize weight regain.

    • A well-balanced diet combined or not with exercise induces fat mass loss without any decrease of bone mass despite bone micro-architecture alterations in obese rat

      2013, Bone
      Citation Excerpt :

      Physical activity by itself could also lead to a moderate body weight loss [40]. However, when physical activity is combined with diet therapy, it can improve the loss of weight, abdominal fat mass, and circumference in obese human [40–42] as observed in our animal study. Similar loss of fat mass due to exercise training has been already observed in obese Wistar rats as well as in obese diabetic Zucker rats [9,23].

    • A randomized, controlled, supervised, exercise trial in young overweight men and women: The Midwest Exercise Trial II (MET2)

      2012, Contemporary Clinical Trials
      Citation Excerpt :

      Exercise is recommended by virtually every public health organization for weight loss and prevention of weight regain [7–13]. However, the role of exercise is generally considered secondary to energy restriction [14–16]. Indeed, an argument can be made that exercise is ineffective for weight loss.

    View all citing articles on Scopus
    View full text