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Role of physical activity and exercise in obesity

INTRODUCTION

The optimal management of overweight and obesity starts with a combination of diet, exercise, and behavioral modification. In addition, some patients eventually require pharmacologic therapy or bariatric surgery.

Physical exercise and activity are important components of weight loss, particularly in maintaining long-term weight loss. A dose-response relationship has been demonstrated in overweight adult women between the amount of exercise and long-term weight loss [1].

Physical activity is defined as any activity that involves the use of one or more large muscle groups and raises the heart rate [2]. It is a component of energy balance that is particularly important in the pathogenesis of obesity and in its treatment.

The components of energy expenditure are basal metabolic activities (such as heat production for maintenance of body temperature, maintenance of ionic gradients across cells, and resting cardiac and respiratory function), thermogenesis, and physical activity (graph 1).

This role of physical activity in the pathogenesis and treatment of obesity will be reviewed here. Basal metabolic activities, thermogenesis, and other interventions in the management of obesity are reviewed separately. (See "Pathogenesis of obesity" and "Overview of therapy for obesity in adults" and "Behavioral strategies in the treatment of obesity" and "Dietary therapy for obesity".)
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References Top
  1. Jakicic, JM, Winters, C, Lang, W, Wing, RR. Effects of intermittent exercise and use of home exercise equipment on adherence, weight loss, and fitness in overweight women: a randomized trial. JAMA 1999; 282:1554.
  2. Zachwieja, JJ. Exercise as treatment for obesity. Endocrinol Metab Clin North Am 1996; 25:965.
  3. Schoeller, DA, Fjeld, CR. Human energy metabolism: what have we learned from the doubly labeled water method. Annu Rev Nutr 1991; 11:355.
  4. US Department of Health and Human Services. Physical Activity and Health: A Report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 1996.
  5. Williamson, D, Madans, J, Anda, R, et al. Recreational physical activity and ten-year weight change in a US national cohort. Int J Obes 1993; 17:279.
  6. Ravussin, E, Lillioja, S, Knowler, WC, et al. Reduced rate of energy expenditure as a risk factor for body-weight gain. N Engl J Med 1988; 318:467.
  7. Crespo, CJ, Smit, E, Troiano, RP, et al. Television watching, energy intake, and obesity in US children: results from the third National Health and Nutrition Examination Survey, 1988-1994. Arch Pediatr Adolesc Med 2001; 155:360.
  8. Robinson, TN. Reducing children's television viewing to prevent obesity. JAMA 1999; 282:1561.
  9. Samaras, K, Kelly, PJ, Chiano, MN, et al. Genetic and environmental influences on total-body and central abdominal fat: the effect of physical activity in female twins. Ann Intern Med 1999; 130:873.
  10. Tremblay, A, Despres, J, Maheux, J, et al. Normalization of the metabolic profile in obese women by exercise and a low fat diet. Med Sci Sports Exerc 1991; 23:1326.
  11. Despres, JP, Pouliot, MC, Moorjani, S, et al. Loss of abdominal fat and metabolic response to exercise training obese women. Am J Physiol 1991; 261:E159.
  12. Blair, SN, Kohl, HW 3rd, Barlow, CE, et al. Changes in physical fitness and all-cause mortality. and all-cause mortality. A prospective study of healthy and unhealthy men. JAMA 1995; 273:1093.
  13. Blair, SN, Kampert, JB, Kohl, HW 3rd, et al. Influences of cardio-respiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women. JAMA 1996; 276:205.
  14. Sandvik, L, Erikssen, J, Thaulow, E, et al. Physical fitness as a predictor of mortality among healthy, middle-aged Norwegian men. N Engl J Med 1993; 328:533.
  15. Leon, AS, Connett, J, Jacobs, DR, et al. Leisure-time physical activity levels and risk of coronary heart disease and death. The Multiple Risk Factor Intervention Trial. JAMA 1987; 258:2388.
  16. Paffenbarger, RS Jr, Hyde, RT, Wing, AL, et al. The association of changes in physical-activity level and other lifestyle characteristics with mortality among men. N Engl J Med 1993; 328:538.
  17. Ekelund, LG, Haskell, WL, Johnson, JL, et al. Physical fitness a predictor of cardiovascular mortality in asymptomatic North American men: The Lipid Research Clinics Mortality Follow up Study. N Engl J Med 1988; 319:1379.
  18. Lee, CED, Blair, SN, Jackson, AS. Cardiorespiratory fitness, body composition, and all-cause and cardiovascular disease mortality in men. Am J Clin Nutr 1999; 69:373.
  19. Wei, M, Kampert, JB, Barlow, CE, et al. Relationship between low cardiorespiratory fitness and mortality in mormal-weight, overweight, and obese men. JAMA 1999; 282:1547.
  20. Lee, L, Kumar, S, Leong, L. The impact of five-month basic military training on the body weight and body fat of 197 moderately to severely obese Singaporean males aged 17-19 years. Int J Obes 1994; 18:105.
  21. Epstein, LH, Wing, RR. Aerobic exercise and weight. Addict Behav 1980; 5:371.
  22. Ballor, D, Keesey, R. A meta-analysis of the factors affecting exercise-induced changes in body mass, fat mass and fat-free mass in males and females. Int J Obes 1991; 15:717.
  23. Garrow, J, Summerbell, C. Meta-analysis: Effect of exercise, with or without dieting, on the body composition of overweight subjects. Eur J Clin Nutr 1995; 49:1.
  24. Hadjiolova, I, Mintcheva, L, Dunev, S, et al. Physical working capacity in obese women after an exercise program for body weight reduction. Int J Obes 1982; 6:405.
  25. Slentz, CA, Duscha, BD, Johnson, JL, et al. Effects of the amount of exercise on body weight, body composition, and measures of central obesity: STRRIDE--a randomized controlled study. Arch Intern Med 2004; 164:31.
  26. Ross, R, Dagnone, D, Jones, PJ, et al. Reduction in obesity and related comorbid conditions after diet-induced weight loss or exercise-induced weight loss in men. A randomized, controlled trial. Ann Intern Med 2000; 133:92.
  27. Irwin, ML, Yasui, Y, Ulrich, CM, et al. Effect of exercise on total and intra-abdominal body fat in postmenopausal women. A randomized controlled trial. JAMA 2003; 289:323.
  28. Donnelly, JE, Hill, JO, Jacobsen, DJ, Potteiger, J. Effects of a 16-month randomized controlled exercise trial on body weight and composition in young, overweight men and women: the midwest exercise trial. Arch Intern Med 2003; 163:1343.
  29. Pavlou, KN, Krey, S, Steffee, WP. Exercise as an adjunct to weight loss and maintenance in moderately obese subjects. Am J Clin Nutr 1989; 49:1115.
  30. Jakicic, JM, Marcus, BH, Gallagher, KI, et al. Effect of exercise duration and intensity on weight loss in overweight, sedentary women: a randomized trial. JAMA 2003; 290:1323.
  31. Foreyt, JP, Goodrick, GK. Factors common to successful therapy for the obese patient. Med Sci Sports Exerc 1991; 23:292.
  32. Miller, WC, Koceja, DM, Hamilton, EJ. A meta-analysis of the past 25 years of weight loss research using diet, exercise or diet plus exercise intervention. Int J Obes 1997; 21:941.
  33. Wadden, TA, Foster, GD, Wang, J, et al. Clinical correlates of short- and long-term weight loss. Am J Clin Nutr 1992; 56:271S.
  34. Kayman, S, Bruvold, W, Stern, JS. Maintenance and relapse after weight-loss in women: Behavioral aspects. Am J Clin Nutr 1990; 52:800.
  35. Wadden, TA, Kuehnel, RH, Wilk, J, et al. Exercise in the treatment of obesity: Effects of four interventions on body composition, resting energy expenditure, appetite and mood. J Consult Clin Psychol 1997; 65:269.
  36. Schoeller, DA, Shay, K, Kushner, RF. How much physical activity is needed to minimize weight gain in previously obese women? Am J Clin Nutr 1997; 66:551.
  37. Grundy, SM, Blackburn, G, Higgins, M, et al. Physical activity in the prevention and treatment of obesity and its comorbidities. Med Sci Sports Exerc 1999; 31:S502.
  38. Gibbons, RJ, Balady, GJ, Bricker, JT, et al. ACC/AHA 2002 guideline update for exercise testing: summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines). Circulation 2002; 106:1883.
  39. Andersen, RE, Wadden, TA, Bartlett, SJ, et al. Effects of lifestyle activity vs structured aerobic exercise in obese women. JAMA 1999; 281:335.
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