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 glycemia 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 Phenylpropanoline 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)