Abstract
SummaryThere is a need for updated practice recommendations on exercise in the management of overweight and obesity in adults. We summarize the evidence provided by a series of seven systematic literature reviews performed by a group of experts from across Europe. The following recommendations with highest strength (Grade A) were derived. For loss in body weight, total fat, visceral fat, intra‐hepatic fat, and for improvement in blood pressure, an exercise training program based on aerobic exercise at moderate intensity is preferentially advised. Expected weight loss is however on average not more than 2 to 3 kg. For preservation of lean mass during weight loss, an exercise training program based on resistance training at moderate‐to‐high intensity is advised. For improvement in insulin sensitivity and for increasing cardiorespiratory fitness, any type of exercise training (aerobic, resistance, and combined aerobic or resistance) or high‐intensity interval training (after thorough assessment of cardiovascular risk and under supervision) can be advised. For increasing muscular fitness, an exercise training program based preferentially on resistance training alone or combined with aerobic training is advised. Other recommendations deal with the beneficial effects of exercise training programs on energy intake and appetite control, bariatric surgery outcomes, and quality of life and psychological outcomes in management of overweight and obesity.
Highlights
Physical activity is recognized as a “pillar” in the management of overweight and obesity, in parallel with dietary counseling, behavioral support, medication, and, in some instances, bariatric surgery.[1]
Physical activity is defined in broad terms as “any bodily movement produced by skeletal muscles that results in energy expenditure.”[2]. Exercise is viewed as a subcategory of physical activity that is “planned, structured, repeated with a given purpose, to maintain or increase physical fitness”
The value of physical activity and exercise for maintaining health and preventing noncommunicable diseases is acknowledged as a public health “best buy,”[3,4] the role they may have for weight control remains debated both in the scientific[5] and lay literature.[6]
Summary
There is a need for updated practice recommendations on exercise in the management of overweight and obesity in adults. For loss in body weight, total fat, visceral fat, intra-hepatic fat, and for improvement in blood pressure, an exercise training program based on aerobic exercise at moderate intensity is preferentially advised. An exercise training program based on resistance training at moderate-to-high intensity is advised. An exercise training program based preferentially on resistance training alone or combined with aerobic training is advised. Other recommendations deal with the beneficial effects of exercise training programs on energy intake and appetite control, bariatric surgery outcomes, and quality of life and psychological outcomes in management of overweight and obesity
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