Wednesday, November 24, 2021, 11:51 AM
At the XVII SEEDO Congress, special emphasis was placed on “the need to make patients aware that obesity is a disease, and that training can help them avoid relapses in the long term.” Dr. Javier Butragueo, pointed out that “the combination of pharmacology and exercise would have a positive effect on the loss of fat weight”.
A paradigm shift is required in the care of people with obesity, the main challenge being to ensure the maintenance of their autonomy with age, quality of life and prevention of weight gain. In this context, physical exercise plays an essential role and, therefore, it is essential to have up-to-date practical recommendations on the type of physical activity to be carried out in the treatment of overweight and obesity, all within specialized medical units and in Primary Care, and with the close collaboration of sports centers.
In the opinion of Dr. Javier Butragueo de la Obesity Management School (Madrid), “the identification of the mechanisms that mediate the adaptive response to exercise could discover molecular targets that guide the design of new drugs to better treat chronic diseases”.
For his part, Dr. Csar Bustos Martn, founder of “There are no excuses and pronaf”, and member of the SEEDO, provides an essential key to achieve the best results in the majority of overweight and obese patients. In his opinion, “training programs must be attractive, appropriate to consumer expectations, flexible for use in real life, and affordable and profitable for health services,” says this expert, who recalled that ” weight, it’s a life-long process, not a short-term goal “; in addition, it emphasizes that asking and evaluating, advising, assisting and organizing are essential premises to achieve success in a weight loss program “.
According to the latest publications on training and obesity management, to preserve muscle mass during weight loss, an exercise training program based on lower body strength and higher at a moderate-high intensity is recommended.
Likewise, it was confirmed that interventions that combine high intensity aerobic exercises and exercises with high loads produce beneficial effects that are superior to any other modality in reducing abdominal adiposity, improving muscle tone and increasing cardiorespiratory capacity.
To improve insulin sensitivity and increase cardiorespiratory capacity, cardiovascular resistance training, strength training, or a combination of both may be recommended; Even if the obese person is physically fit, they may still be able to do high intensity interval training (after a thorough cardiovascular risk assessment and under supervision). In this sense, Csar Bustos indicates that “we already have solid evidence that shows how the improvement in cardiorespiratory capacity in the long term neutralizes the adverse effects of increased adiposity as well as cardiovascular risk factors”.
As demonstrated in this scientific session, good muscle capacity is capable of regulating glucose metabolism and insulin resistance in people with type II diabetes and obesity. As Javier Butragueo detailed, “exercise is used to generate a response at a metabolic, immune and structural level; we should not only stay with energy expenditure, since it would be a mistake and we would underestimate the role that muscle has in health and disease. “.
Skeletal muscle comprises approximately 40% of the total human body mass in a healthy weight individual. Together, the skeletal muscle and the heart account for almost 30% of the energy consumption at rest and almost 100% of the increase in energy consumption during exercise. Skeletal muscle maintenance is a dynamic process: it is constantly repaired and regenerated; however, the regenerative capacity of the skeletal muscle decreases in obesity.
The problem in adults with obesity is not sarcopenia (loss of mass, strength and function of the muscles) but dinapenia (loss of the ability to generate force) and, for this reason, “it is essential to focus on improving the metabolic component and structural of the muscle “, indicates the coordinator of the GT of Exercise of SEEDO. The latest research in exercise has shown that it is possible to improve functional capacity even with more than 80 years, showing that it is never too late to improve and add quality to the years of life.
Another aspect to assess is that the different exercise modalities can interact with the circadian rhythm, which can modulate their metabolic effects. In the words of Dr. Butragueo, “optimizing the schedule of exercise sessions could help existing therapeutic interventions for the treatment of metabolic diseases.”
Currently, there are changes in the strength training recommendations on the breaks between sets, the volume or intensity at which a person with obesity should train, and even the number of days necessary to achieve improvements at the metabolic level. However, as Dr. Javier Butragueo pointed out, “these recommendations are forgotten if they are not assumed by the population; in this sense, sports centers and their professionals are the most important resources available to citizens to achieve their goals. related to the creation and maintenance of an active and healthy lifestyle, with weight loss being one of the most important objectives “.
The researchers advocated including the prescription of physical exercise in medical treatments; However, Butragueo indicated that “the reality is that spaces and specialists are needed who can carry out this work, so gyms must adapt to this context and form part of the ecosystem of services that favors a healthier and healthier society. “.
Furthermore, as Csar Bustos stressed, “the exercise strategy selected in overweight and / or obese subjects, with the aim of improving the levels of health and body composition related to exercise, should be evaluated by professionals specialized in Health Sciences. Physical Activity and Sports, while the nutritional and eating strategy must fall to a dietitian-nutritionist “.