Physical activity is defined as any bodily movement produced by the contraction of skeletal muscles. This contraction leads to an increase in energy expenditure above the resting level. The energy cost associated with physical behaviour is called energy expenditure.
Reducing sedentary behaviour, along with promoting and monitoring regular physical activity, is one of the basic elements in the treatment of obesity and its complications.
What are the benefits of physical activity?
In addition to its benefits in terms of obesity, physical activity is linked to reduced mortality and morbidity.
Being physically active is also associated with psychological health, including better mood and fewer anxiety or depression syndromes. The benefit increases as one moves from inactivity to moderate activity. On the other hand, when moving from moderate to intense activity, the benefit is less significant.
In particular, physical exercise increases the demand for fatty acids as a muscle energy substrate and induces an increase in adrenergic tone. These two effects also induce lipolysis in adipose tissue. Regular physical activity is a major means of reducing excess visceral adiposity and the risk of cardio-metabolism.
Physical activity has beneficial effects on weight, particularly if it is combined with action on diet.
Interventions involving both physical activity and diet (rich in protein, for example) with behavioural strategies are in fact more effective than interventions involving physical activity or diet separately with behavioural strategies. People who only change their level of physical activity, without changing their diet, can only benefit from very limited weight loss. However, sport can be a factor in preventing further weight gain or weight regain after initial weight loss.
Physical activity and contraindications :
As a general rule, there are no real contraindications to physical activity in obese adults. There are, however, restrictions depending on the severity of the obesity and associated pathologies.
Depending on the severity of the obesity, the increase in body mass, whether simply excess weight or morbid obesity, reduces locomotion capacity. Physical activities become more difficult to perform as BMI increases. Obesity increases mechanical stress on the two main joints of the lower limb, the hip and knee. Combined with the effects of excess weight on joint surfaces, these stresses encourage the onset of joint pain and, subsequently, osteoarthritis.
When weight reduction has been initiated, suitable activities include weight-bearing activities or activities that involve the upper body more(cycling or swimming). In terms of restoring locomotor capacity, muscle strengthening is of major interest. The spontaneous reduction in physical activity in obese people is accompanied by a reduction in muscle mass. Muscle-strengthening exercises that will stimulate an increase in lean body mass and help stabilise the joints of the lower limbs should be favoured.
Certain pathologies associated with obesity will restrict the indications for physical activity:
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Serious accidents (myocardial infarction, sudden death):
These accidents mainly occur in sedentary subjects who begin high-intensity activity without prior training or medical assessment. This means that sedentary obese patients with a high cardiovascular risk should be treated with caution.
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Adverse events associated with physical activity:
These events, such as musculoskeletal trauma, although common, usually remain minor, especially for moderate-intensity activities such as walking.
Overall, the benefits of physical activity and the application of the above recommendations outweigh the risks.
Some recommendations:
Any activity should take into account the person’s current physical condition and physical abilities. People should be encouraged to reduce the amount of time they spend watching television or using a computer.
According to WHO recommendations, for adults aged between 18 and 64, physical activity includes leisure, travel(walking or cycling), work activities, household chores, leisure activities, sports or planned exercise in the context of daily family or community life.
People should be encouraged to do at least 150 minutes (2 h 30) a week of moderate-intensity physical activity. This physical activity can be broken down into one or more sessions of at least 10 minutes. To obtain additional health benefits, adults should increase the duration of their moderate-intensity physical activity to 300 minutes (5 h) per week or perform 150 minutes per week of sustained-intensity physical activity, or an equivalent combination of moderate- and sustained-intensity activity. Muscle-strengthening exercises involving the main muscle groups should be performed at least 2 days a week.
People who are obese and have lost weight should, however, perform 60 to 90 minutes of physical activity a day to avoid regaining the weight.
A few tips:
- Walk as much as possible
- Walk to work or to the shops
- If you take the bus, get off one stop before your destination
- Use the stairs instead of the lift or escalator
- Avoid sitting for long periods, especially when watching television
- If you have a garden, spend more time working in it
- If you have a dog, walk it more often and for longer periods of time
Above all, avoid giving up, aim for maintenance and help “to keep up the pace”. Regular monitoring is an important asset! It will allow you to adapt your physical activity according to your motivation and physical condition.
