Exercise therapy in adiposity

Exercise is indispensable in losing weight. But adequate sports programs for obese people are rare.

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In order to lose weight you would change your diet, consume less calories and try to exercise more. This combination is the best pre-condition to lose weight. In the IFB outpatient clinic obese patients get an individual diet plan in their weight loss program. They also get recommendations for more exercise and - if it's medically possible - a prescription for rehabilitation sports. The patients could use it in a sports center near their home. Generally sports that don't strain the joints such as swimming, cycling and walking are recommendable. Many obese patients for example start with walks and increase their exercise program with growing performance ability. The goal should be about one hour of exercise two or three times a week. Apart from cardio, strength training is also recommendable. If there already metabolic or cardiovascular diseases you should consult your physician and you should choose a sports center with specially trained instructors.

Sports do not only help against the extra weight but also against the comorbidities, explains Dr. Stefanie Lehmann, scientist and exercise specialist at the IFB: "Many obese patients suffer from type II diabetes. This disease often leads to muscle damage. For those patients it is extremely important to exercise regularly since that is how the muscles regenerate. Exercise also fuels the metabolism and increases the effect of insulin in the blood. With a tgargeted and structured exercise therapy the blood sugar levels can be enhanced to the point that the patient needs less medication or even doesn't have to inject insulin at all." Another positive effect of regular exercise is the strenthening of the muscles. "This leads to an increase of the basic metabolic rate. That means that the body already burns more energy in a state of rest," says Lehmann.

Studies have shown that a certain amount of strain is needed in order to effectively activate the metabolism. Therefore it is necessary to achieve 85 percent of the maximum perfomance ability or 85 percent of the maximum heart rate. It is sensible to run a stress test with a sports physician before planing such an exercise program. As of right now however, there are no recommendations of professional associations concerning the form, intensity or frequency of training for morbidly overweight patients. The prevention and rehabilitation courses that are now precribed for obese patients are rather means of self help in order to include more exercise in the everyday life and to motivate the patients to do more sports.

Therefore scientists at the IFB also do research in the field of exercise therapy: the scientists around Prof. Matthias Blüher research how different training affects the abdominal fat. Dr. Arne Dietrich and his team research the effects of exercise therapies after a bariatric surgery (gastric bypass). The results of those studies should also contribute in the development of effective exercise therapies for adipose patients.

Doris Gabel

Keywords: obesity treatment, exercise