Obesity

Overview of Obesity

obesity is due to a combination of genetic, environmental, and behavioral factors that results in an energy imbalance to promote excessive fat storage.¹ Obesity can be defined by a client's body weight, body fat percentages, and body mass index (BMI). The World Health Organization uses a BMI of >30 as the cutoff for class 1 obesity, with levels of >35 for class 2 and >40 for class 3.² Waist circumference can be used with BMI to assess health risks related to obesity. Circumferences of ≥88 cm for women and ≥102 cm for men indicate greater risk for disease. Sedentary lifestyle is a significant risk factor for obesity and the primary cause of endurance impairments for individuals with obesity.³ Clients need regular examinations to assess blood pressure, blood glucose, and lipid levels. Clients benefit from interdisciplinary management that may include pharmacologic agents, nutritional counseling, and behavioral therapy.¹

Comorbidities to Consider

• Obesity is a significant risk factor for developing diabetes, heart disease, and a number of other medical conditions.³

Obesity Is an Increased Risk for:

Client Examination

Keys to Examination of Clients

• Take considerable time to talk with your clients with obesity to understand their previous experiences and beliefs about exercise before developing a plan. These individuals should be counseled on the benefits of an exercise program and must be allowed to help design their exercise program.

• A medical history will help identify conditions that may limit their exercise tolerance.

• Exercise activities may exacerbate existing degenerative conditions, cause chafing and skin disorders, and may make an individual susceptible to falling and heat intolerance.

• Assess client's body composition, BMI, and waist circumference before the client begins an exercise program.

Recommended Baseline Testing of Fitness Levels

• Based on the client's current functional status, determine a method for assessing the individual's exercise tolerance. The most common methods for clients with obesity are the half-mile walk, 6-minute walk, or the 10-meter walk.^4,5

• The client's heart rate, blood pressure, and perceived exertion levels should be regularly assessed at the outset of the exercise program.

Exercise Prescription

Type: Walking, aquatic exercise, weight training

Intensity: Low to moderate intensities, 40%–70% of maximum

Duration: Up to 60 minutes

Frequency: Five to seven times per week.

Getting Started

Group exercise can be recommended for those clients with similar weight-loss challenges. Clients with morbid obesity may best start an exercise ...