Chapter 18 - Special Considerations for Weight Management

american college of sports medicine recommendations on physical activity and weight loss! 1. minimal weight loss 2. 2-3 kg 3. 5-7.5 kg

1. less than 150 min/wk 2. greater than 150 min/wk 3. greater than 225-420 min/wk

evidence suggests that even a minimal weight loss of _____ can reduce cardiovascular risk factors

2-3%

the main goal for individuals with overweight and obesity is to progress to _____ in order to achieve clinically significant weight loss

250-300 minutes per week of moderate to vigorous intensity aerobic exercise

data suggest that obesity continues to be a significant public health concern in the US, with ____ of adults in the US classified as overweight or obese and ____ categorized as obese

68.5%; 34.9%

considerations with individuals with overweight or obesity prior to exercise testing: medications that may

alter HR or BP response at rest or during exercise

considerations with individuals with overweight or obesity prior to exercise testing: various musculoskeletal or orthopedic conditions may require

alternate testing modalities to the treadmill such as leg or arm ergometry

physical activity is a target focus of interventions that are linked to

an improvement in health outcomes and increased success with weight loss when combined with caloric restriction

in order to be consistent with ACSM's updated exercise preparticipation health screening recommendations, individuals with overweight and obesity should be

assessed first for current exercise participation; known cardiovascular, metabolic, or renal disease or signs or symptoms of these diseases and planned exercise intensity level

physical activity is found to be one of the

best predictors of long-term weight maintenance after weight loss

based on the ACSM's guidelines for exercise testing and prescription, perhaps some of the most important information to obtain from this group of individuals is a ?

clear understanding of the person's current level of physical activity and the presence of signs, symptoms, and/or known cardiovascular, metabolic, or renal disease

a primary consideration for exercise testing for individuals with overweight and obesity is the presence of

comorbidities which can be associated with increased cardiovascular risk and decreased exercise performance

energy intake = ?

energy expenditure

through increasing physical activity levels, individuals who are overweight or obese can

expend more calories, thus aiding in a negative energy balance

although this concept of weight management appears to be straightforward, there is a constellation of causes contributing to overweight and obesity. Contributing factors include, but are not limited to,

genetic, epigenetic, social and physical environment, biological, and psychological variables that can lead to positive energy balance

additional information to collect as part of the preparticipation exercise screening would be

height, weight, BP, HR, waist circumference, medications, musculoskeletal/orthopedic problems, psychological conditions and amount of sedentary time

in order to individualize treatment appropriately, other pertinent information to collect prior to initiating an exercise program for an individual who is overweight or obese may include a thorough medical history due to an

increased risk of associated comorbidities

due to the presence and degree of severity of these comorbidities, there is a potential for a _____ in individuals with overweight and obesity

low exercise capacity

however, low fitness levels are commonly observed in individuals with overweight and obesity. Therefore, this often translates into an initial exercise prescription that is

low volume of aerobic exercise with a goal to progress time, intensity , and frequency appropriate for the individual

______ is primarily determined by the energy balance equation

maintenance of body weight

considerations with individuals with overweight or obesity prior to exercise testing: if no known cardiovascular, metabolic, or renal disease is present, an exercise test...

may not be required for a low- to moderate-intensity exercise program

______ tests should also be considered with overweight and obese individuals

non-weight-bearing modes of testing, such as cycle ergometer tests

one useful strategy to progress the volume of physical activity for individuals with overweight and obesity is to

prescribe multiple daily bouts of at least 10 minutes in duration

considerations with individuals with overweight or obesity prior to exercise testing: assess the

presence of comorbidities which are associated with cardiovascular risk and exercise performance

there are negative __, ___, and ___ of overweight and obesity for the U.S population

psychosocial, biomedical, and economic implications

furthermore, maintaining a weight loss of 3-5% may result in lowering of

risk factors associated with overweight and obesity comorbidities

considerations with individuals with overweight or obesity prior to exercise testing: reduced exercise capacity may require

submaximal exercise testing protocols considering the initial workload

examples of appropriate exercise tests for individuals with overweight or obesity include, but are not limited to,

the modified Balke, 6-minute walk, modified naughton, and YMCA cycle ergometry

overweight and obesity are associated with an increased risk of

type 2 diabetes, hypertension, dyslipidemia, coronary heart disease, stroke, some forms of cancer, musuloskeletal problems, respiratory problems, and elevated risk of all-cause and CVD mortality

supplementary factors for the clinician to assess prior to program participation for individuals with overweight or obesity are history of

weight gain and loss over time, dietary habits, physical activity history , family history of obesity, barriers to weight loss and individual weight and physical activity goals