WHAT ROLE DOES PHYSICAL ACTIVITY IN THE TREATMENT OF OBESITY?
Exercise or physical activity is defined as a rhythmic activity, elevating the heart rate to levels above repose and involve the coordinated use of the large muscle groups. There are two types of physical activity, everyday activities and programmed physical exercise. Everyday activity is that which can be done in ones everyday life (climb stairs, habitually get off the bus one stop before the habitual, etc.) and are easy to do. Programmed exercise is that in which a determined amount of extra time is dedicated (swimming, running, etc.).
As we know, obesity is produced by an imbalance between the intake of energy and cardiac expenditure, thus we can assume that any activity that increases cardiac expenditure is an efficient way to lose weight. However, exercise as an isolated treatment method of obesity does not produce substantial changes in weight (a loss of around 0.01-0.09 Kg/week) or of body fat composition (a loss of 0.01-0.02 kg/week of fat mass). Even so, an appropriate integral treatment should consist of a hypocaloric diet and physical exercise. The numerous beneficial effects of physical exercise are, without a doubt, an integral element in the treatment of obesity.
Increasing The Burning Of Basal Energy
Regular exercise increases the number of calories burned like fat; therefore if it is combined with a reduction in the number of ingested calories through a low-fat hypocaloric diet, it accelerates weight loss in a significant manner by obtaining a negative energy balance.
Change In Body Fat Composition
During a hypocaloric diet fat mass (75%) as well as lean mass (25%) is lost. Physical exercise in the integral treatment of obesity has shown a lesser loss of muscle tissue. In addition, being that the lean mass is metabolically more active that the fat tissue, it compensates in part for the decline in calories burned in all of the situations where there is a restriction in calories.
Change In Appetite
It is widely believed that doing exercise to lose weight is incorrect because it stimulates appetite. In non-obese individuals there is an increase of intake to compensate for the loss in energy, but this effect is not seen in obesity. There are in fact studies that relate physical exercise to a lower desire for high fat foods.
Improves Risk Factors Associated With Obesity
The practice of physical exercise is associated with the decline in level of cholesterol (total and LDL) and triglycerides, and an increase in HDL. It has positive effects on blood pressure and glucose metabolism (with a decline in the resistance to insulin). An inverse relationship has been observed between the regular practice of moderate exercise and cardiovascular mortality.
Improves The General Health Of The Individual
Physical activity has positive psychological effects, improving self-esteem and helping to relieve anxiety produced by a state of stress as with a restriction in caloric intake.
However, the introduction of physical exercise everyday in cases of obesity has shown limitations due to associated physical problems (arthrosis, cardiopathy, pulmonary restrictions), an excess of weight and psychological conflicts (shame, insecurity). In general it is recommended that the practice of programmed physical exercise, as well as everyday physical activity, in a regular manner and adapted to the age and physical condition of the individual, to be progressively increased, more than anything in the maintenance phase. It is appropriate for the introduction of exercise to be gradual, to progress in a way that improves the physical condition. Aerobic activities are considered optimum if they can produce a daily caloric burning of 300 Kcal/day, and elevate the heart rate 75-80%, corresponding to the age (220-age). It should develop during a minimum of 30 minutes after 5 minutes of warm-up, 4-7 days a week.
If this is not possible because of the circumstances of the patient, it is considered adequate to increase only everyday physical activity.