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Obesity, physical activity and health

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NAME: TEMITOPE ABAYOMI PROGRAM: MPH COURSE: EXERCISE MEDICINE OBESITY, PHYSICAL ACTIVITY AND HEALTH The concept of obesity, physical activity and health is not a new one. But there is presently a universal concern the growing phenomenon of obesity and lifestyle which is now regarded as an epidemic! 'The 1980s and '90s witnessed and alarming increases in obesity across the globe (1). This epidemic has not been slowed by the new treatment strategies, leading some health professionals to doubt if they can help their patients. A recent audit documented wide variation in the management of overweight and obese patients in general practices in England and uncertainty about which treatments were most effective (2). The question remains, what is obesity and overweight? The World Health Organisation defines overweight as a body mass index of 25.0-29.9 and obesity as a body mass index >30 (3). However, body mass index does not adequately characterise the distribution of the body fat, which is important because excess intra-abdominal fat is an independent predictor of health risk (4). Guidelines recommended measurement of waist circumference, which correlates with visceral fat and indirectly measures central adiposity. An increase risk to health is present when waist circumference exceeds 94cm (37 inches) for men and 80cm (32 inches) for women (1). This definition of obesity and overweight revealed the fact that there is excess of energy stored in the body, but this positive energy becomes a concern if it poises health risk to life and well-being! ...read more.


All these problems complicate life and results in reduced life expectancy in adults. While for an obese or overweight adolescent, 'obesity compounds a common adolescent problem of low self-esteem and can disrupt psychosocial development, interfering with the normal process of adolescence, a timeless journey that prepares the child for adulthood. An obese young person may have difficulty dealing with peers and this communication problem can seriously disrupt normal adolescent development. Psychological complications have been associated with obesity in adolescents, including depression, poor self-image, and difficulties in both the home and social environment (including school)' (11). The overall picture of obesity and overweight seems gloomy but recent research into the realm of energy balance has a lot of hope for obese and overweight patients. 'To effectively intervene, dietetics professionals and other health care practitioners need to address both sides of the energy balance equation when counselling clients and patients' (14). 'Often, the focus on energy intake supersedes the promotion of a physically active lifestyle. Incorporating appropriate and sufficient physical activity into one's life is an essential component of achieving and maintaining a healthful body weight' (6). Traditionally, exercise has been viewed as a universal panacea, providing a wide range of both physical and psychological benefits. Moderate amounts of physical activity have been shown to reduce the risk of premature mortality from all causes (12) ...read more.


Typically, reductions of 500 to 1000 kcal a day are needed to produce weight loss at the recommended levels of 1 or 2 Ib (0.45 or 0.90 kg) a week (19). Strong evidence shows that physical activity results in modest weight loss and increases cardiovascular fitness independent of weight loss. "Lifestyle" strategies that combine a controlled energy diet, increased physical activity, and behaviour therapy provide the most successful treatment for weight loss and maintenance of that weight loss (3). It is important to know how much physical activity is required to prevent unhealthful weight gain in adults (6). A comprehensive review of the evidence suggest that the energy expended in daily physical activity be at least 80% of resting energy expenditure, an activity level equivalent to an additional 60 to 90 minutes of brisk walking in adults who normally engage in only modest amounts of physical activity (20). The recommendation of 30 minutes per day of regular, moderate-intensity activity was challenged because it was insufficient to prevent adult weight gain and fully achieve all the 60 minutes of moderate-intensity physical activity daily to promote a healthful body as well as health and vigour (21). Ultimately control of obesity is likely to require population based strategies to promote healthy eating and increased physical activity. The most effective population based interventions are likely to adopt an integrated, multidisciplinary, and comprehensive approach and involve a complementary range of actions that work at the individual, community, environmental, and policy level (22). ...read more.

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