Important new recommendations on exercise training in the management of overweight and obesity in adults

Important new recommendations on exercise training in the management of overweight and obesity in adults

Synthesis of the evidence and recommendations from the European Association for the Study of Obesity Physical Activity Working Group

Exercise training can help support management of overweight and obesity in adults, and can contribute to health benefits beyond “scale victories”.

The supplement published today in Obesity Reviews, based on the work of an expert group convened under the auspices of the European Association for the Study of Obesity (EASO), provides scientific evidence on health and wellbeing benefits of exercise training for people living with overweight and obesity.

Supplement highlights include a summary of key recommendations; additional developed materials provide infographic tools for health care practitioners (HCPs) and people who are overweight or living with obesity,  and a written interview with the senior scientist who coordinated development of these important new physical activity recommendations, Professor Jean-Michel Oppert.

Open access to the supplement

Infographics

Interview with Professor Jean-Michel Oppert

Synthesis of the evidence and recommendations from the EASO Physical Activity Working Group: a conversation with Professor Jean-Michel Oppert

Exercise training can help support management of overweight and obesity in adults and can contribute to health benefits beyond “scale victories”. The supplement published today in Obesity Reviews presents the scientific evidence around the health benefits of exercise training for people living with overweight and obesity.

In this interview, we are pleased to speak with the senior scientist who led the development of these important new physical activity recommendations together with a working group of experts from across Europe. Professor Jean Michel Oppert  explains how he and his colleagues developed the recommendations, the evidence used to establish them, what the guidelines will mean for people living with overweight and obesity, and how this action-oriented research will support health care practitioners who provide people living with obesity with support and care.

Exercise training (ET), whether aerobic or resistance training or a combination, facilitates improved glucose regulation and provides numerous other physical and psycho–social health benefits. Since ET may influence obesity-related risk at individual and population levels, widespread adoption of ET may be beneficial for people living with overweight and obesity and can help to support weight loss maintenance over the longer term, impacting the prevalence of obesity and related co-morbidities.

Q: Great to meet with you again, Professor Oppert. Please tell us how you and your colleagues came to develop these important new recommendations.

A : Great to talk with you about this collective effort. It is common knowledge that physical activity and exercise form a key « pillar » in the management of overweight and obesity. However we realized the evidence base on on which scientific recomendations should stand, had not been reviewed and synthesized for at least 10 years. Thus we set out to assemble the evidence base that would enable us to produce a set of recommendations that we believe will be of interest to professionals as well as to patients.

Q: There is a tremendous amount of evidence, some of it contradictory, around exercise training for people living in larger bodies. How did you bring together the evidence used to develop these recommendations?

A : We were very fortunate to be able to assemble a wonderful working group comprising top experts from across Europe under the auspices of The European Association for the Study of Obesity (EASO), and we are very grateful for the support it provided. The overall theme of exercise in the management of overweight and obesity was divided into seven topics of major importance, such as the effects of exercise training on cardio-metabolic health, on physical fitness, on appetite and eating behaviour etc. Some of these topics are really quite new; for example we have a paper on the effect of exercise training on liver fat in persons with overweight or obesity.

Each topic was addressed using a similar approach consisting of systematically searching and analysing the available scientific literature, noting key evidence statements, and using this evidence base to design a comprehensive set of recommendations.

Q: These new recommendations will be of great value not only within the EASO Collaborating Centres for Obesity Management, but also to GPs and HCPs across Europe in promoting evidence-based exercise training.

A: We really hope these recommendations will be as widely disseminated as possible. They should be of interest to both professionals and patients. An important output of this work is to stress the importance of providing specific forms of training for specific outcomes, which will improve the overall health of patients. For example, strength training is the recommended form of exercise for improving muscular strength, endurance training is the recommended form of exercise for fat loss (including intra-abdominal and liver fat, recognizing, of course that weight and fat loss with exercise is modest !)  All forms of exercise (endurance training, strength training, or a combination of both) was found to improve cardiorespiratory fitness.

We believe these principles should guide the exercise training  strategy when proposing exercise to persons with overweight or obesity since they show that a goal needs to be defined and agreed upon; this will then lead to a particular type of exercise recommendation. We think the implementation of exercise training programs among persons with overweight or obesity should primarily aim to increase physical fitness, reduce cardiometabolic risk, and improve quality of life.

Q: What screening procedures would you advise for health care professionals recommending exercise training to people living with obesity?

A: Thank you for asking this important question. However, it needs to be said that it was not among the topics for which we systematically searched the scientific literature. What we can say is that a progressive approach is required in most situations. The aim is to individually tailor an exercise prescription to the needs, preferences, capacity, corplence, and health risks of each person. It seems prudent to advise habitually inactive adults with obesity to become more active via  gradual progression in exercise volume by adjusting exercise duration, frequency, and/or intensity.

Q: What will these recommendations mean for people across Europe living with overweight and obesity?

A: These recommendations really emphasize the positive value of exercise for persons with overweight and obesity. The relatively small magnitude of weight loss obtained through exercise, at least when looking at average values, does not diminish in any sense the multiple benefits of exercise on other important physical and psychological health outcomes. With exercise, everything moves in a favourable direction! Therefore, this work should help exercise become an integral part of a comprehensive approach in the management of overweight and obesity. As a starting point, physical activity and exercise should be discussed as part of each encounter between a health professional and a patient with overweight or obesity!

Contact

Professor Jean-Michel Oppert, Department of Nutrition, Pitie-Salpetriere Hospital, Sorbonne University, Paris, France – [email protected]

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