Obesity and Exercise Outline

Risks

• Coronary artery disease
• Hypertension
• Type II diabetes
• Feelings of insecurity, decreased self-esteem and body image

Treatments

• Dietary
  • Low calorie diets
    • Adaptive decrease in energy expenditure
    • Reduced resting metabolic rate
      • reduced body mass
      • not seen when BW is expressed as kcal/kg
    • Decreased muscle mass
    • Reduced norepinephrine induced thermogenesis
    • Decrease in fat cell lipolysis
    • Decrease glycogen stores
      • water weight loss
    • Yo-Yo phenomenon
  • Dietary fat reduction
    • Food less palatable
    • Protein and carbohydrates convert to body fat less readily
    • Blood sugar instability (increased glycemic index)
  • Low carbohydrate diets
    • More promising than once thought
      • Blood lipids
      • Adherence
    • Body converts lean muscle mass and/or dietary protein to glucose via gluconeogenesis
    • Possible initial low energy
    • More pronounced decrease glycogen stores
      • water weight loss
• Pharmacology
  • Phenylpropanolamine
  • Amphetamines
  • Ephedrine, caffeine, aspirin
• Surgical methods
• Exercise
  • Energy cost of activities
  • Post exercise resting energy expenditure
  • Possible long term increase of resting energy expenditure
  • Initial rise in adrenaline-stimulated lipolysis
  • Rise of diet-induced thermogenesis
    • energy cost of digestion, absorption, transformation of storage
    • inconsistent findings
  • Possible increase of muscle mass
    • metabolically active
    • contributes to body aesthetics
  • Increase functional strength
  • Increase health
    • decreases insulin resistance
  • Assists in maintenance of weight loss

Exercise Problems for the Obese

• Balance anxiety
• Muscular weakness
• Pulmonary hypertension
• Low back pain
• Movement restriction
• Orthopedic problems
• Ionic disbalance
• Poor circulation (Diabetics)
• Much perspiration
• Flush skin
• Hypenea & Dyspnea
• Tachycardia
• Arterial hypertension
• Body heat build up
• Ketonuria
• Chafing
• Muscle cramps
• Orthostatic hypotension
• Heavy strain on joints

Factors to Consider

• Duration of obesity
• Maturation
• Motivation
• Mental State
• Exercise History
• Eating Patterns
• Socialization

Program Support

• Medical evaluation
• Exercise instruction and consultation
• Nutritional counseling
• Behavioral counseling

Behavior Modification

• Positive reinforcement
• Self-regulation
  • Specify their goal
  • Establish commitment to change
  • Manage their physical and social environments
  • Execute the components of self-regulation
    • self-monitor
      • behavior oriented
        • training journal
        • diet record
      • results oriented
        • anthropometrics
        • medical tests
    • self-evaluate
    • self-consequate
  • Generalize changes to lifestyle

References

Astrup A and Tourbro S (1993)

Barrows K and Snook J (1987)

Brehm BJ et al (2003)

Daly PA and Landsberg L (1991)

Daly PA et al (1993)

Foster GD et al (2003)

Kirschenbaum DS (1986)

Lawton CL et al (1993)

Tremblay A, Després JP, Bouchard (1985)

Samaha FF et al (2003)