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.