Obesity: Exercising, not dieting, may be key to avoiding health risks


GUIDELINES for obesity management tend to focus on weight loss through calorie restriction and increased physical activity. Weight loss is often difficult to sustain, and repeated weight loss attempts are associated with adverse health outcomes.

A recent review shows that increased physical activity and improvements in fitness levels can reduce the risk of obesity-related health conditions and mortality, even in the absence of weight loss.

An obesity management approach that primarily focuses on improving fitness rather than weight loss may be at least as effective as weight loss in reducing the adverse health consequences of obesity.

According to the Centers for Disease Control and Prevention (CDC)Trusted Source, 42.4% of adults in the United States were obese in 2017–2018, a marked increase from 30.5% in 1999–2000.

An increase in adults attempting to lose weight has mirrored this surge in obesity rates. However, the restriction in calorie intake that is necessary for weight loss can be difficult to sustain over a prolonged period.

Moreover, many individuals are unable to achieve their target weight, while those who manage to often struggle to maintain it.

Both of these situations can lead to frustration and reduced adherence to the weight loss program, eventually resulting in a cycle of gaining and losing weight.

This fluctuation in weight is known as weight cycling, and it is associated with adverse health outcomes.

The rapid rise in obesity rates despite the increased focus on reducing weight reflects the limits of this weight loss-centric approach to obesity management.

Yet, guidelines for obesity management continue to advocate the practices of limiting calorie intake and increasing physical activity levels.

Over the past 2 decades, some scientists have argued that an approach focused on weight loss may be misplaced when it comes to obesity management.

Instead, they suggest that a “fat-but-fit” approach based on increasing physical activity levels and improving cardiorespiratory fitness should be the primary focus for those looking to lose excess body weight.

Advocates of the fat-but-fit approach to obesity treatment argue that improving fitness, even in the absence of weight loss, can help reduce the risk of cardiovascular disease and mortality.

While physical activity refers to any movement that results in energy expenditure, cardiorespiratory fitness is a measure of overall physical fitness.

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