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

Feet On Scale

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)

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