Is Physical Activity a Worthwhile Option for the Management of Severe Obesity?

Abstract

Physical activity is recommended by experts in the medical and surgical management of severe obesity. However, there is no specific physical activity recommendation for this population. Yet, individuals with severe obesity need to be considered specifically because of higher prevalence of comorbidities, poorer quality of life and physical fitness compared to people with less severe obesity. In addition, they have several weight related or unrelated barriers that can prevent them from reaching recommended level of physical activity. Weight loss is an important outcome for obese patients. However, physical activity is associated with no or moderate weight loss, and there is a large weight loss variability between individuals. More and more evidence confirms that physical activity interventions are feasible and effective to maintain weight loss and improve health of individuals with severe obesity beyond weight loss. Thus, to avoid frustration and disappointment, no focus on weight loss should be done during physical activity intervention. Overall, more high quality studies are now required to improve the level of evidence and provide information on the optimal physical activity support, modes of delivery, timing and dose in individuals with severe obesity. In addition, the assessment of implementation outcomes (compliance, adverse outcomes and satisfaction) and cost-effectiveness analyses are required to support that physical activity intervention is a worthwhile option in the medical and surgical treatment of severe obesity.