by: brittany hogh, dan gonzalez & matt h. overweight: an excess of weight relative to height or...
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BY: B R I TTA NY H O G H , D A N G O NZ A L E Z & M ATT H
Exercise for Overweight & Obese Individuals
Chapter 6
Overweight: an excess of weight relative to height or BMI of 25-29.9
Obese: excess body fat or a BMI of 30 or higher
BMI: body mass index; a measure of a person’s weight relative to height
Waist circumference >40 inches for men & >35 inches for females
(5)
Criteria for Obesity
Statistics in the U.S.
More than one-third of U.S. adults (35.7%) are obese
In 2008 medical costs associated with obesity were estimated to be $147 billion
The cost for those who are obese estimated to be $1429 or higher than those of normal weight
(1)
Statistics in the U.S. continued
Non-Hispanic African Americans have the highest age-adjusted rates of obesity (49.5%) compared to Mexican Americans at 40.4%, all Hispanics at 39.1% and non-Hispanic whites at 34.3%
Nearly 45% if women & 30% of men are trying to loose weight at any given time (textbook)
They spent $40 billion annually on gym memberships, exercise equipment, weight lose supplements and programs
(1)
Facts
No state in the U.S. met Healthy People 2010’s goal to lower obesity prevalence to 15% (1)
Chronic Conditions Associated with Being Overweight or Obese
HypertensionType 2 diabetesHyperlipidemiaHeart DiseaseStrokeVarious types of
cancerOsteoarthritisRespiratory problemsGallbladder disease(5)
Changes in the Body
Cardiovascular system Increased workload for the heart Experience elevated heart rate Increase in blood pressure Greater blood volume Greater blood sodium content Aneurism Varicose veins develop Arteriosclerosis & Atherosclerosis Experience edema in the lower extremities resulting in
poor circulation
(5)
Arteriosclerosis & Atherosclerosis
• Arteriosclerosis: when blood vessels thicken and harden making them less flexible
• Atherosclerosis: fatty build up or plaque accumulates in the arteries , causing the vessels to become narrow or obstructed
(5)
Changes in the Body
Musculoskeletal system Osteoarthritis Inflammatory arthritis Lumbar spine & soft tissue conditions Osteoporosis Gait problems Limits physical function & disability can occur Balance & locomotion problems
(5)
Changes in the Body
Respiratory system Increases risk for pulmonary embolism, pneumonia &
respiratory failure Limits respiratory capacity Diminishing lung volume Interfering with breathing mechanics Impairing gas exchange Sleep apnea There is a link between obesity & asthma
(5)
Changes in the Body
Digestive System Acid reflux occurs more frequently putting an
individual at risk for esophageal cancer Gall bladder complications (including gallstones &
gallbladder disease) Accumulation of fatty deposits around the liver More constipation which promotes hemorrhoid
development
(5)
Changes in the Body
Hormone Levels Effected & Interrupted including: Leptin: produced by fat cells that inhibits the desire to
eat and increases energy expenditure in an attempt to maintain body weight.
Adiponectin: produced by fat cells that acts as an anti-inflammatory & decreases the risk for heart attack.
Insulin: released by the pancreas in response to increasing blood glucose
Estrogen: produced by the ovaries and by adipocytes. Ghrelin: produced by stomach cells that stimulates
appetite and increases energy storage. (5)
Exercise Precautions
Warning: most likely have other risk factors Increased risk for a cardiac event or strokeIncreased Stress on Joints Greater risk for heat exhaustion
(hyperthermia)Body fat distribution
(4)(5)
Barriers for Exercise
Standard exercise equipment will not accommodate an obese individual
Low physical capacity (lack of energy)Low self esteemLack of timeFear of injuryBody fat distribution
Intra-abdominal fat (android or apple shape: dangerous)
Lower body fat (gynoid or pear shape)
(5)
Benefits of Exercise
Improves cardiovascular & respiratory functioning Lowers BP & LDL levels Improve heart & lung functioning
Decreases risk for type 2 diabetesImproves moodReduces overall discomfort
Research shows that losing just 14 lb of weight likely reduces the pressure on the knees by 30lb
Promotes better sleep
(4) (5)
Obesity Treatment
Drugs Appetite suppressants (Sibutramine) Orlistat Precautionary side effects: increases blood pressure
Surgery Decrease size of stomach
Lap band Gastric bypass Stomach stapling Sleeve gastrectomy (2) All surgeries have can have complications
Diet & Exercise Need to be closely monitored Limit empty calories Increase nutrient dense foods
(2)(5)
Recommendations for Exercise
Exercise Testing Cycle ergometer with an oversized seat Most exercise testing should be customized
Initial workload should be limited to 2-3 mets Small incremental increases of .5-1 met per
testing stage
(5)
Exercise Prescription
Medical clearance is necessary before exercise
Weight lose is the primary goalAerobic exerciseResistance training
(5)
Aerobic Exercise
Frequency: 5-7 days per week moderate intensity (40 -60% VO2r) for 30-60 minutes
As cardiovascular and respiratory improvements occur they can increase intensity to 50-75% VO2r
Strive for 150 minutes a week & gradually increase to 300 minutes a week
5-10 minute warm up & a 5-10 minute cool down
(5)
Resistance Training Recommendations
Obese individuals with normal mobility can participate in most traditional resistance programs
Those with restricted range of motion should focus on simpler movements
Frequency: 2-3 times per week Minimum of 8-10 exercises should target all major
muscle groups Minimum of 1 set 8-12 repetitions
(5)
Benefits of Resistance Training for Obese Individuals
Improves muscular strength and endurance, improves functional capacity, and enhances neuromuscular functioning
Increases bone mass helping to prevent osteoporosisThese changes reduce physiological stress
(5)
General Tip for Weight Loss
Strive for a 5-10% weight loose over 3-6 monthsChange diet & exercise behaviors for long term weight
lossCreate an energy deficit of 500 kcals a day for a weekly
weight lose of 1 pound
(5)
Integrate Physical Activity into Everyday Activities
Take the stairsPark farther from the doorTake a short walk at lunchTurn off the TVTake walk breaks from workWear a pedometer for monitoring your
activity
(4)
Case Study: Firefighting Obesity: The Not-So-Silent Problem
Overweight & obese firefighters missed five times as much work because of injury than those who had a normal, healthy weight
Costs of obesity related absences were $1682.90 per fire fighter & $74.41 per overweight firefighter
(3)
References
1. CDC. (2012, August 13). Center for disease control and prevention. Retrieved from http://www.cdc.gov/obesity/data/adult.html
2. David, D. (2012). Pubmed health. In National Center for Biotechnology Information. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004552/
3. The NSCA TSAC Program. Obesity in firefighters: Not-So-Silent Problem. NSCA. Retrieved from http://www.nsca-lifet.org/Education/E-Learning/Firefighting-obesity--The-Not-So-Silent-Problem/
4. Schmidt, S. (2012, January 10). Obesity and exercise. Retrieved from http://www.acsm.org/access-public-information/articles/2012/01/19/obesity-and-exercise
5. Williamson, P. (2011). Exercise for special populations. (1st ed.). Baltimore: Lippincott Williams & Wilkins.
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