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SPORTS MEDICINE :
SPORT PSYCHOLOGY :
MEDICAL: CONDITIONS: OBESITY :
PHYSICAL EXERCISE AND FITNESS :
JOURNAL ARTICLE:
Exercise Aspects of Obesity Treatment
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Exercise Aspects of Obesity Treatment
Matthew A. McQueen, MD
Ochsner J. 2009 Fall; 9(3): 140143.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3096271/
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INTRODUCTION
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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.
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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
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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.
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snip
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Topics Discussed in This Article:
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PREPARTICIPATION EVALUATION
EXERCISE SPECIFICS
OBESITY FITNESS GUIDELINES
CONCLUSIONS
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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REFERENCES
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Jakicic J. M., Clark K., Coleman E., 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;33(12):21452156. [PubMed]
Donnelly J. E., Blair S. N., Jakicic J. M., Manore M. M., Rankin J.
W., Smith B. K. American College of Sports Medicine. American College of
Sports Medicine position stand: appropriate physical activity intervention
strategies for weight loss and prevention of weight regain for adults. Med
Sci Sports Exerc. 2009;41(2):459471. [PubMed]
Canadian Society for Exercise Physiology. PAR-Q and You. Gloucester,
Ontario: Canadian Society for Exercise Physiology; 1994.
American College of Sports Medicine Position Stand and American Heart
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American College of Sports Medicine. ACSM's Guidelines for Exercise
Testing and Prescription. 7th ed. Philadelphia, PA: Lippincott Williams &
Wilkins; 2006.
Haskell W. L., Lee I. M., Pate R. R., et al. Physical activity and
public health: updated recommendation for adults from the American College
of Sports Medicine and the American Heart Association. Circulation.
2007;116(9):10811093. [PubMed]
Wallace J. P. Obesity. In: Durstine J., Moore G., editors. ACSM's
Exercise Management for Persons With Chronic Diseases and Disabilities.
2nd ed. Champaign, IL: American College of Sports Medicine, Human
Kinetics; 2003.
Maron B. J., Zipes D. P. Introduction: eligibility recommendations for
competitive athletes with cardiovascular abnormalitiesgeneral
considerations. J Am Coll Cardiol. 2005;45(8):13181321. [PubMed]
Poirier P., Despr J. P. Exercise in weight management of obesity.
Cardiol Clin. 2001;19(3):459470. [PubMed]
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