Managing the Obese Patient, With Emphasis on Exercise. Kevin deWeber, MD Family Physician Primary Care Sports Medicine USUHS. Objectives. Review the benefits of exercise in obesity Discuss the relative benefits of exercise vs. diet in achieving and maintaining weight loss
Kevin deWeber, MD
Primary Care Sports Medicine
Coronary artery dz.
OVERALL MORTALITY HIGHER!
CervixObesity is associated with increased risk of co-morbid conditions:
* overweight/obesity“Trends in overweight and physical activity among U.S. mlitary personnel, 1995-1998.”
Despite the protection against cardiovascular dz. and all-cause mortality that cardio-respiratory fitness incurs, obesity still has its problems.
* all-cause mortality that cardio-respiratory fitness incurs, obesity still has its problems.How good is exercise alone for weight loss?
* all-cause mortality that cardio-respiratory fitness incurs, obesity still has its problems.
Ross R 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 Jul 133(2):92-103
* research using diet, exercise, or diet plus exercise intervention.”What is the effect of exercise intensity on weight loss?
* exercise for weight loss?
Jakicic JM et al. Effects of intermittent exercise and use of home exercise equipment on adherence, weight loss, and fitness in overweight women: a randomized trial. JAMA 1999 Oct;282(16):1554-60.
“The effects of 18 months of intermittent vs. continuous exercise on aerobic capacity, body weight and composition, and metabolic fitness in previously sedentary, moderately obese females.”
* composition?What role does exercise have in weight loss maintenance?
HIGH RISK component.
Coronary artery dz
Type 2 diabetes
Age (men>45, W>55)
LDL > 160
HDL < 35
Impaired fasting gluc
FH of premature CAD
SmokingRisk-stratifying obese patients
(there is no one single best method) component.
1. Decreased caloric intake
2. Increased exercise
3. Behavioral modification
4. +/- Pharmacotherapy
5. +/- Surgery
Behavior modification strategies, extended treatment, and physical activity are excellent predictors of weight loss during treatment.Foreyt JP, Goodrick GK. Evidence for success of behavior modification in weight loss and control. Annals of Internal Medicine 1993;119:698-701.
National Heart, Lung, and Blood Institute. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the evidence report. 1998.
* physical activity are excellent predictors of weight loss during treatment.What kind of exercise is best for obesity treatment?
Kraemer WJ et al. Influence of exercise training on physiological and performance changes with weight loss in men. Med Sci Sports Exer 1999 Sep;31(9):1320-9.