Exercise & Obesity: Overcoming Barriers



The month of January brings one of the busiest times of the year. For many of us, a plan to get more exercise tops our list of New Year’s Resolutions. Unfortunately, less than five percent of adults participate in 30 minutes of daily physical activity and only one in three adults achieves the recommended amount of physical activity each week. Most people agree that physical activity is an essential component to maintaining a healthy lifestyle. However, it is important to acknowledge that exercise often presents challenges to individuals who are overweight and obese. There’s much more to the “just move more” advice for weight loss. In this article, we will explore a few challenges to exercise and potential solutions.

Exercise does not have to be difficult. Obesity specialists often interchange the terms “exercise” and “physical activity.” Exercise is often associated with a negative connotation of arduous, unobtainable and unenjoyable labor, which creates a mental barrier for many people. Physical activity is a more acceptable concept and conveys simply moving. Physical activity can involve parking your car farther from the store, taking the stairs instead of the elevator, or breaking up a one-hour walk into ten-minute increments over a six-hour period; all are suitable means of obtaining daily physical activity. The adult recommendation for physical activity is one hour a day, most days of the week, and this can be easily obtained by walking for one hour a day. This is easy, safe, and can be very enjoyable. Walking is effective activity for both the weight loss and maintenance stages of weight management.

As the body increases energy expenditure in the form of increased physical activity, systems within the body will work to defend the set point (the body’s programmed weight locked within the brain in the hypothalamus). As more calories are burned, the body will compensate for the loss of fat by increasing hunger signals and reducing satiety. This leads to overeating, eating large portions and consuming more “comfort foods.” The end result is “eating back” (restoring) calories that are lost to physical activity. To combat this physiological routine, always eat a balanced diet – first and foremost – and do not over-diet.

During the weight-loss process, it is tempting to cut calories too low, and this causes key nutrients to be lost, as well. Although the number on the scale may go down quicker in the beginning, it is deceiving; the weight loss is typically only water and muscle-weight, not fat. Severe caloric restriction not only results in muscle loss but also reduces metabolism, making it harder to lose additional weight (weight-loss plateau) and easier to gain subsequent weight. This cycle also leads to even more food cravings.

Finding strategies to overcome exercise barriers is essential to achieving physical fitness goals and ensuring not only proper weight loss, but most importantly, weight maintenance.

When increasing physical activity, a well-balanced diet is crucial. Consume adequate protein and healthy fats to reduce food cravings and help with satiety. In addition, be sure that the feelings or thoughts of hunger and craving are legitimate. “Head hunger” is more related to a psychological need than a true physical hunger, and is a natural occurrence when making dietary changes. Often, cravings are related to habits rather than a true physiological need for a nutrient or food. Remember: obesity is a disease. There is a series of biochemical signals that regulates hunger and satiety that are altered as a result of obesity. For obese individuals who need to lose weight to eliminate chronic medical conditions or prevent disease, it is sometimes necessary to seek the help of an obesity clinician who is well-versed in FDA-approved weight-loss medication to help with hunger, cravings and metabolic preservation.

When beginning an exercise program, it is important to consult first with a specialist. This can be a physical therapist, exercise therapist or your physician. If not performed correctly, exercise can result in injury, depending on the extent of excess weight and types of physical activity. Increased torque on weight-bearing joints, especially the knees and ankles, can increase the risk of injury for individuals carrying excess weight. It is important to avoid injuries that can lead to diminished mobility, as this will not only reduce confidence in physical activity but also increase the risk of additional weight gain. Stretching, slow progression and patience are key to starting an exercise regimen. Proper nutrition, rest, and listening to the body to differentiate muscle growth from dangerous muscle pain are also key to avoiding injury from physical activity. Individuals with 100 or more pounds of excess weight should consider starting with chair exercises, water aerobics and bike riding. These activities are safer, gentler on the joints and still effective for cardiovascular fitness and weight reduction.

While physical activity is one of the most essential factors of weight maintenance, consistency is extremely difficult to maintain. As caloric intake and other metabolic factors fluctuate, physical activity serves as a method for energy expenditure to offset factors that impede weight loss. Ways to increase consistency with physical activity include: finding an activity that is enjoyable, creating accountability (can be in the form of a fitness tracker, calendar, an accountability partner or group fitness).

The benefits of exercise are well described. In obesity, a regular exercise regimen causes improvement in terms of insulin sensitivity, lipid and lipoprotein profile and blood pressure, as well as reduced risk of death. The benefits are not just metabolic – exercise also improves circulation and heart and lung function. Psychologically, exercise increases the sense of self-control, reduces stress, increases the ability to concentrate and contributes to better sleep.

Exercise is not always easy, yet it is often suggested as a weight-loss solution, as if it were effortless. It is important to remember that there are several challenges that create barriers for engaging in physical activity. Finding strategies to overcome the barriers is essential to achieving physical fitness goals and ensuring not only proper weight loss, but most importantly, weight maintenance.

Let the New Year’s Resolutions begin!



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