Obesity rates around the world have tripled over the past four decades, leading to an increase in a wide variety of health problems, including cardiovascular disease, diabetes and cancer. In an attempt to address these health issues, diets and weight loss efforts have also rapidly escalated, with many of these efforts carrying their own risks.
However, new search shows that when it comes to helping obese people stay healthy and reduce the risk of death, increasing physical activity and improving fitness appear to be greater than focusing on weight loss. The study by Siddhartha Angadi, assistant professor of kinesiology in the Faculty of Education and Human Development at AVU, and Glenn Gaesser, professor of exercise physiology at the College of Health Solutions at Arizona State University, was published this month in the journal iScience.
“We would like people to know that fat can be fit and that fit and healthy bodies come in all shapes and sizes,” Gaesser said. “We realize that in a culture obsessed with weight, it can be difficult for programs that aren’t focused on weight loss to gain traction. We are not necessarily against weight loss; we just think that shouldn’t be the primary yardstick for judging the success of a lifestyle intervention program.
Angadi said this point is “particularly important when considering the physiological realities of obesity”.
“Body weight is a highly inherited trait, and weight loss is associated with substantial metabolic alterations that ultimately thwart the maintenance of weight loss,” Angadi said.
In addition to the risks associated with obesity, individuals also run risks during the weight cycle, commonly referred to as the “yo-yo” diet, which is a repetitive pattern of losing and regaining weight. Angadi and Gaesser said that using a weightless approach not only serves the treatment of health problems associated with obesity, but also reduces the health risks associated with this type of diet.
“Risks associated with the weight cycle include muscle loss, fatty liver disease and diabetes,” Angadi said. “By focusing on fitness rather than weight loss, people can reap the benefits of exercise while avoiding the risks associated with weight cycling.”
Current public health guidelines recommend that adults accumulate 150 to 300 minutes per week of moderate-intensity physical activity or 75 to 150 minutes per week of vigorous-intensity physical activity.
“But it’s important to note that the benefits of exercise depend on the dose, with the greatest benefits coming from simply stepping out of the couch potato zone to do at least one moderate-intensity activity,” he said. Gaesser said. “It is also important to stress that physical activity can be accumulated throughout the day. For example, several short walks throughout the day (even as short as two to 10 minutes each) are just as beneficial as a long health walk.
In the study, Angadi and Gaesser cite recent research that focused on the magnitude of the reduction in mortality risk associated with weight loss compared to that associated with increased physical activity or cardiorespiratory fitness. The risk reduction associated with improved fitness and physical activity was consistently greater than that associated with intentional weight loss. They also looked at the extent of reduction in cardiovascular disease risk markers that are associated with either weight loss or increased physical activity. They arrived at these conclusions by reviewing research that analyzed data pooled across a multitude of studies (meta-analyzes) that were conducted over a range of time periods and across large geographic areas.
The researchers recognize the limitations of the existing body of research, including the fact that this area relies heavily on epidemiological studies that do not definitively establish cause and effect, and note that only large randomized controlled clinical trials can fully examine the results from using a fitness-focused approach to optimize the risk of cardiometabolic mortality in obese people.