Physical Activity Therapy Although exercise alone is only moderately effective for weight loss, the combination of dietary modification and exercise is the most effective behavioral approach for the treatment of obesity. The most important role of exercise appears to be in the maintenance of the weight loss. Currently, the minimum public health recommendation for physical activity is 30 min of moderate intensity physical activity on most, and preferably all, days of the week. Focusing on simple ways to add physical activity into the normal daily routine through leisure activities, travel, and domestic work should be suggested. Examples include walking,. | Chapter 075. Evaluation and Management of Obesity Part 5 Physical Activity Therapy Although exercise alone is only moderately effective for weight loss the combination of dietary modification and exercise is the most effective behavioral approach for the treatment of obesity. The most important role of exercise appears to be in the maintenance of the weight loss. Currently the minimum public health recommendation for physical activity is 30 min of moderate intensity physical activity on most and preferably all days of the week. Focusing on simple ways to add physical activity into the normal daily routine through leisure activities travel and domestic work should be suggested. Examples include walking using the stairs doing home and yard work and engaging in sport activities. Asking the patient to wear a pedometer to monitor total accumulation of steps as part of the activities of daily living is a useful strategy. Step counts are highly correlated with activity level. Studies have demonstrated that lifestyle activities are as effective as structured exercise programs for improving cardiorespiratory fitness and weight loss. The Dietary Guidelines for Americans 2005 summarizes compelling evidence that at least 60-90 min of daily moderate-intensity physical activity 420-630 min per week is needed to sustain weight loss http dietaryguidelines dga2005 . The American College of Sports Medicine recommends that overweight and obese individuals progressively increase to a minimum of 150 min of moderate intensity physical activity per week as a first goal. However for long-term weight loss a higher level of exercise . 200-300 min or 2000 kcal per week is needed. These recommendations are daunting to most patients and need to be implemented gradually. Consultation with an exercise physiologist or personal trainer may be helpful. Behavioral Therapy Cognitive behavioral therapy is used to help change and reinforce new dietary and physical activity behaviors.
