Physical Activity in Obesity Management
Key messages for healthcare professionals
- Regular physical activity induces a wide range of health benefits in adults across all body weight categories, even in the absence of weight loss.
- Aerobic and resistance exercise can favour the maintenance or improvements in cardiorespiratory fitness, mobility, strength and muscle mass during obesity-management interventions. This can be important, as these outcomes are not targeted and sometimes are negatively affected by other therapies, such as caloric restriction, medications and bariatric surgery.
- Weight stigma is linked to reduced engagement in physical activity. The role of healthcare professionals is to provide non-judgemental support for physical activity as a health-promoting behaviour, regardless of body size or obesity complexity.
- In Ireland body weight tends to increase with age. Physical activity is particularly important for preserving lean tissue and reducing metabolic effects of higher levels of fat mass in older adults due to the changes in body composition associated with ageing (higher levels of fat tissue and lower levels of lean tissue).
Recommendations
- Aerobic physical activity (30–60 minutes of moderate to vigorous intensity most days of the week) can be considered for adults who want to:
- Increase cardiorespiratory fitness (Level 2a, Grade B)1 and mobility (Level 2a, Grade B)2;
- Optimise the maintenance of muscle mass and physical function during weight loss (Level 2a, Grade B)3;
- Achieve small amounts of body weight and fat loss (Level 2a, Grade B)4;
- Achieve reductions in abdominal visceral fat (Level 1a, Grade A)5-7 and ectopic fat such as liver and heart fat (Level 1a, Grade A)7, even in the absence of weight loss; and
- Optimise weight maintenance after weight loss (Level 2a, Grade B)4,8.
- For adults living with overweight or obesity, resistance training may promote weight maintenance or modest increases in mass or fat-free mass and mobility (Level 2a, Grade B)9.
- Increasing exercise intensity, including high-intensity interval training, can achieve greater increases in cardiorespiratory fitness and reduce the amount of time required to achieve similar benefits as from moderate-intensity aerobic activity (Level 2a, Grade B)1,10.
- Regular physical activity, with and without weight loss, can improve many cardiometabolic risk factors in adults who have overweight or obesity, including:
- Hyperglycemia and insulin sensitivity (Level 2b, Grade B)1,11,12;
- High blood pressure (Level 1a, Grade B)13,14; and
- Dyslipidemia (Level 2a, Grade B)15,16.
- Regular (120 or more minutes per week) aerobic physical activity may improve overall mental health and health-related quality of life in adults who are middle aged or older living with overweight or obesity (Level 2, Grade B)17,18. There is evidence to suggest that regular exercise (dance therapy) may improve body image (Level 3, Grade C)19.
Key messages for patients living with obesity
- Physical activity has a wide range of health benefits in adults across all body weight categories, even in the absence of weight loss. It improves mobility, quality of life, fitness, strength and helps you to maintain muscle during obesity management.
- Increasing physical activity is one of the key components of all obesity-management strategies but weight loss should not be the sole outcome by which the success of physical activity therapy is judged.
- In Ireland, body weight tends to increase with age. Physical activity is particularly important for preserving muscle in older adults due to the changes in body composition that happen as we get older.
- Weight stigma is proven to reduce physical activity for people living with obesity. Seek non-judgemental support for physical activity as a health-promoting part of your daily routines, regardless of your body size or obesity complexity.
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