Chapter 8 ResistanceTraining Strategies for Adult Obesity Copyright
Chapter 8 Resistance-Training Strategies for Adult Obesity Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Prevalence of Obesity • Epidemic in US • US adults overweight = 66. 3 percent – More than 32. 2 percent also classified as obese • Non-Hispanic blacks and Mexican. Americans have highest rates Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Prevalence of Obesity • Ongoing trend over last three decades • Framingham Heart Study showed long-term risks over 10 - to 30 -year period of becoming obese greater than 25 percent Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Obesity Defined • Male’s average percentage of body fat – Normal = 15 to 18 percent – Obese = greater than 22 to 25 percent • Female’s average percentage of body fat – Normal = 22 to 25 percent – Obese = greater than 35 to 38 percent Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Direct Costs of Adult Obesity • Estimated at $75 billion dollars annually – Over eight years, 56 percent increase • Related to comorbidities associated with obesity, including: – – Diagnosis Treatment Physician visits Hospitalizations Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Indirect Costs of Adult Obesity • Lost worker productivity • Lost income due to disability • In 1995 study, estimated at $48 billion annually Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Etiology of Adult Obesity • Body weight regulation includes multiple factors: – – – Genetic Hormonal Metabolic Dietary Environmental Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Etiology of Adult Obesity • Not necessarily caused by sedentary lifestyle, lack of motivation, or noncompliance • Primarily related to imbalances between energy intake and energy expenditure • Obese individuals in state of positive energy balance • Negative energy balance results in weight loss Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Body Mass Index (BMI) • Calculated by dividing weight in kg by height in meters squared • Ideal BMI range based on government and WHO recommendations • Epidemiological studies assess relationship between weight and chronic disease Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
BMI • Lower BMI means less risk for: – – – Cardiovascular disease Hypertension Diabetes Several types of cancer Associated comorbidities Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Limitations of BMI • Quality of body weight not distinguished – E. g. , fat vs. fat-free mass, bone, or protein • Body builders, professional football players, and others with high amount of lean body mass relative to total body size classified as obese Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Limitations of BMI • Exercise professional needs to consider both overall body mass and quality of body mass Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Body Fat Distribution • Location of body fat • Central adiposity – Android obesity – Excess body fat carried in abdominal area and trunk • Gynoid obesity – Excess body fat carried in hips and thighs Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Central Adiposity • Men = waist circumference of 40 or more inches • Women = waist circumference of 35 or more inches • Leads to greater risk for cardiovascular disease, diabetes, stroke, and certain cancers Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Central Adiposity • Resistance training must target increases in total energy expenditure to decrease total body fat Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Resistance Training and Weight Loss • Not recommended as substitute for aerobic exercise for weight loss – Which causes higher energy expenditures • Unable to preserve loss of fat-free mass often seen during weight loss Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Benefits of Resistance Training • Improves muscular strength, endurance, and overall mobility • Used as complement to aerobic exercise during periods of weight loss Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Benefits of Resistance Training • May help extremely obese resume activities of daily living • Improves neuromuscular function, ability to perform activities of daily living, and aerobic exercise Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Research Recommendations for Aerobic Training • Necessary to differentiate between exercise recommendations for weight loss versus other primary outcomes – E. g. , muscular fitness • Aerobic exercise through walking elicits greatest energy expenditure over fixed time period Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Research Recommendations for Aerobic Training • 200 minutes of moderate-intensity aerobic, physical activity per week in combination with dietary restrictions promotes loss of 1 to 2 pounds per week Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Research Supports Resistance Training • Maintains or minimizes loss of lean body mass during periods of weight loss • Helps individuals maintain fat-free mass and resting energy expenditure during weight loss – Particularly when targeting large muscle groups Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Program Design Considerations • Needs, goals and abilities • Functional capacity • Limitations – Weight-bearing vs. non-weight-bearing, orthopedic, ROM, and flexibility • Primary outcomes Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Screening Tests for Obese Adults • • • Medical history Current medication use Weight history Body composition Primary care physician clearance Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Screening Tests for Obese Adults • Exercise testing • Monitoring of blood pressure before, during, and after training Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Cautions Related to Medications • Trainer should understand dosage, frequency, reason for prescription, and potential influences on resistance training responses • Sibutramine may increase heart rate and blood pressure • Orlistat may cause fecal incontinence, oily spotting, and flatus Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Weight History • Consider history of average body weight • Include weight gains and losses during adulthood • Understanding can help determine individual’s motivation for changing behaviors • Helps identify barriers to success Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Body Composition • Combination of fat mass and fat-free mass • Tool for assessing fat distribution and health risks • Numerous anthropometric methods available – Refer to Table 8. 4 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Resistance Exercise Testing • May be inappropriate for some obese adults • Determine risks following review of medical history and client consultation • Testing protocols such as 1 RM for upper/lower body or multiple-RM tests generally safe • Use either free weights or weight machines Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Program Components • Incorporate progressive overload • Consistently increase amount of work performed following adaptations Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Program Components • Provide novices appropriate instruction, supervision, and feedback to ensure appropriate training stimulus/overload schedule • Various scales exist to measure intensity Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
OMNI Scale for Resistance Exercise Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
ACSM Repetition Recommendations • Healthy individual: – 1 set of 8 to 12 repetitions for 8 to 10 exercises utilizing major muscle group • Obese individual: – 10 to 15 repetitions per set with lower load – 2 to 3 sets per exercise Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Dynamic Activities • Allow for greater ROM, slower, controlled rhythmical movements, and normal breathing pattern during lifting • Include multi-joint activities – E. g. , weight squats, seated chest press • Mimic functional movements used in activities of daily living Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Resistance Training Machines • May not fit obese individual and requires modifications • Less likely to mimic activities of daily living Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Free Weights • Require training and spotter • Require balance and stability that may carry over to everyday activities • Weight selection flexible – E. g. , DBs, BBs, laundry detergent jugs Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Free Weights • May include other equipment – E. g. , resistance tubing, stability balls, medicine balls • Variety and flexibility may promote compliance Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Behavioral Considerations • Compliance especially problematic for sedentary and deconditioned individuals • Many obese individuals choose exercise for reasons outside themselves – May hamper compliance Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Behavioral Considerations • Measure motivational readiness for change to determine likelihood of compliance • Review sample 24 -Week Program Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Motivational Readiness to Change Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
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