Sports and obesity: what seems incompatible at first glance, on closer examination, is one of the most important measures for weight loss and control. Only special circumstances of the overweight should be considered. In many industrial nations, the average body weight is steadily increasing as a result of increased caloric intake and reduced physical activity (about 2 kg per decade), and the number of overweight and seriously overweight people is steadily increasing. On average, about 20 percent of the European population is overweight.
Weight and fat distribution
The so-called body mass index (or body mass index, BMI) serves as a measure of body weight: the standard values are identical for women and men. For disease risk, the pattern of fat distribution is more important than absolute body weight. Fat accumulation in the abdominal area is associated with higher risks of diabetes and heart disease than fat distribution on the extremities. The ratio of the circumference of waist to hip circumference (in cm) gives information about this and should normally be less than 0.95 for men and less than 0.85 for women. Obese are not just "guilty".
The fatty tissue forms various hormones and messengers, whose role is not very clear, but which seem responsible for the increase in fat deposits. The regulation of body weight is not fully understood until today. In 30 to 40 percent of cases of obesity genetic factors, ie heredity, involved, the rest is caused by behavior and lifestyle.
From different sides to the extra pounds
In the knowledge of the complexity of the problem of overweight, a multi-pronged treatment is preferred today, which includes not only classical nutritional counseling but also adequate physical activity and mental measures for lasting behavioral change. The goal of treatment must be to achieve realistic targets. The achievement of a normal weight would be desirable, but is usually not realistic for the overweight. Even a relatively small weight loss of about 10 percent of the starting weight is already associated with a significant reduction in the accompanying disease risks. Every kilo counts.
A low and continuous weight loss of 1 to 2 kg per month is more promising in the long run than a rapid weight loss in a short time, which usually corresponds to an (unwanted) loss of water and muscle tissue. Losing weight is not difficult to maintain a lower weight but very much.
Do not just count calories
The basis of the treatment of obesity is still the nutritional counseling with the intention to achieve a balanced, low-fat diet, measures against behavioral problems (snacking, eating, frustration, etc.) to show what must always be done individually to the understanding of the Behavior change and motivation to consolidate. In some cases, the targeted use of drugs to reduce fat absorption in the gut or to give a faster feeling of satiety is indicated.
On the other hand, surgical measures such as the application of a gastric band or the aspiration of fat cells (usually also with cosmetic intention!) Should be reserved for overweight people after several failed attempts at therapy. The offer of different diets "off the shelf" is as broad as ineffective. The body accustomed to a given calorie intake will respond to the sole calorie reduction with a restriction of its calorie consumption.
The result is usually a leveling of calorie conversion to a lower level without measurable effects on body weight. It is therefore all the more important to combine the reduced (or optimized) calorie intake through the change in diet with a customized physical activity program, thereby increasing calorie consumption. This forces the body to attack the body's own (fat) reserves when the calorie balance is at a lower level.
The art of weight loss is to consume more calories over a longer period than are absorbed through the diet (= negative calorie balance) without suffering from malnutrition or musculoskeletal disorders.
Sport: the will would be there, but ...
When choosing suitable forms of physical stress, it should be borne in mind that obese people use their joints to gain significantly more weight due to the constantly increased weight load, and that comparatively low loads are already high intensities for them. What is accomplished for a normal weight loosely in the "speech speed" leads to overweight soon to violent wheezing and shortness of breath.
This circumstance is of importance, as a little intense physical exercise intends to burn fats, but at more intense loads predominantly carbohydrates (and in case of bad training condition increasingly anaerobic) are used to cover the energy demand! Many obese people who want to do sport in good intentions, but who quickly overstrain and therefore hardly achieve any effective calorie consumption fail. Another important aspect is that fats are used predominantly in the musculature, an increase in muscle mass thus can significantly increase the potential of fat burning (under stress and at rest).
This in turn is the most efficient by force training, but strength training is only exceptionally among the currently recommended forms of exercise for overweight, although just on resistance devices, the load could be very finely adjusted and adapted to the individual requirements! The knowledge of the circumstances mentioned increases the chances of success of a weight reduction and this success is motivation and ultimately decisive for the consolidation of all weight-reducing measures.
The treatment of the overweight must be on at least three levels (nutritional advice, eating behavior change, physical activity). It usually places high mental and physical demands on people who are willing to accept a license and can be very time-consuming. However, the high failure rate in the treatment of obesity and its high risk of comorbidities justify this commitment and is the basis for long-term success. With appropriate adjustment of the physical intensity, an overload of cardiovascular and joints is easy to avoid and the training progress achieved motivate a lasting change in behavior. The therapeutic goal is not the return to ideal weight, but the long-term keeping of a reduced body weight.