Obesity and Exercise

OBESITY
&
Exercise
By
Prof. Sawsan El Ghazali
&
Assis. Prof Diaa Marzouk
OBESITY
 an excessive accumulation of
body fat for given body size based
on muscle & bone (frame size).
 for men Fat > 25% of total body
weight.
 for women Fat > 30% of total
body weight.
Overweight
 Is an excess of total body weight

including muscle mass,
 So a person could have above
normal body weight due to
muscle accumulation associated
with weight lifting or physical
exercise.
 That is why obesity is not
synonymous with being
overweight.
Ideal weight
 There is no single established

standard of the ideal weight but
there is instead what we call the
 Desired or Optimal body weight
that is used now as a reference.
To establish an optimal
body weight
 Weight determination
 Comparison of body
circumferences or diameter.
 Measuring Skin fold thickness.
 Comparison of body mass index
(BMI) with recommended
standards, which is suitable
method for judging whether too
fat or too thin.
Types of Obesity
1. According to number or size of

fat cells,
2. According to fat accumulation
and distribution,
3. According to weight.
1. According to number or
size of fat cells
There are three main types of obesity:
1. Hyperblastic obesity:
Excessive number of fat cells
Usually associated with childhood
2. Hypertrophic obesity
Increased fat cell size
Develop later in life and associated
with metabolic imbalance
3. Hyperblastic - hypertrophic obesity
Increased in number & enlarged fat
cells.
2. According to fat
accumulation and distribution
Two forms:
1. Android obesity:
It is the male pattern of obesity in
which fat deposition primarily is in the
abdomen and trunk. (Apple shape)
2. Gyenoid obesity (Pear Shaped People)
In those people, fat accumulates
around the hips (usually females).
Fat distribution
 It is the ratio of waist

circumference to hip circumference
 “Waist-hip ratio” (WHR) is a simple
objective method for estimating the
pattern of regional fat distribution.
AWHR > 0,8 in women is
considered a degree of
android obesity sufficient to
increase the health risk of
cardiovascular diseases and
gall stone formation, and thus
needs weight control.
3. According to weight
 It is a simple useful three levels

classification of obesity
 Defined by the
Percentage overweight
 used most often by insurance
companies to determine body
mass index.
Body Mass Index (BMI)
 Is calculated by the following equation:

[Weight in Kilograms (KG)/Height in meter2 ]
Grades of BMI
< 18 Underweight
Grade I 18 -<25 Normal
Grade II 25 -<30 Overweight
Grade III >30 Obese
 20% overweight or BMI >25
(27 for men)
 Determine that risk to health

begins when the body mass
exceed this level and weight loss
becomes medically indicated.
 40% over weight or BMI > 30:
 Represents a level at which

medical intervention becomes
strongly indicated and
corresponds to upward increase
in the mortality curve.
 100% overweight or BMI > 35,
the risks of morbidity and
mortality would be greatly
increased.
Class Percentage of (Body mass Prevalence
over weight index among
(BMI) obese
Mild 20-40 25-30 90.0%
Moderate 41-100 30.1-35 9.5%
Severe >100 >35 0.5%

Other methods of
assessment of obesity
 Corpulence index= actual

weight/desirable weight. This
should not exceed 1.2.
 Ponderal index= Height
(cm)/cube root of body weight
(kg)
 Broca index= Height (cm) - 100
Causes of obesity
 Overeating (habit, pleasure,
psychological)
 Physical inactivity 95%
Imbalance between food intake and
energy expenditure.
 Inheritance
 Endocrinal causes (5% only)
Health risks/Hazards/
complications of obesity
1- Psychological:
emotional problems particularly among
adolescents, needs psycho-social
therapeutic intervention.
2- Mechanical disability:
Flat feet, scoliosis, osteo-arthritis, low
back pain, abdominal hernias, varicose
veins, also adipose tissue under the
diaphragm interfere with respiration
and predispose to bronchitis;
3- Metabolic complication:
 Diabetes mellitus,
 High cholesterol,
 Gall stones are associated with obesity,
 Fatty Liver
4- Skin complications
infections particularly in skin flexures
eg: intertrigo below the breasts.
7- Accidents:
At home they may trip over the carpet
and spill kettles of boiling waters over
themselves.
In street, can’t quickly escape traffic.
6- Respiratory complications:
The increased difficulty in breathing
may lead to Co2 retention and
subsequent drowsiness.
7-Complications attributed to gynecology and
obstetrics:
 Amenorrhea could be a risk factor in genital
tract tumors.
 Affects the dose of hormone replacement
therapy after menopause.
8- Obesity as a problem in surgery:

 Exposure field is difficult,
 Wound healing is prolonged,
 Post operative wound infection.
9- Obesity and cardiovascular system
It increases risk of
 Hypertension, also
 coronary heart disease is associated
 High blood cholesterol level,
 Usually obese person do not practice
exercises,
 Much worse when it is associated with
smoking.
Obesity is a Modifiable
Risk Factors
Stress
Physical Inactivity
Vascular Changes
Obesity
Lipid Profile
High Cholesterol > 200mg/dl
HighLDL > 160 mg/dl
Low HDL < 40 mg/dl
Triglycerides > 200mg/dl
Hypertension
Cerebrovascular
Coronary Heart Disease
Disease Myocardial infarction/ Sudden Death
Learn Program for weight
control
The word “LEARN” are the Initials of:
 L= Life style (regular meals, eat slowly, chewing food
well, Purchase healthy food, avoid open buffet, etc)
 E= Exercises (regular exercise)
 A= Attitude (negative attitude towards

obesity)
 R= Relationship (social support to loose

weight)
 N= Nutrition (lowering caloric intake to less

than 800 cal/day)
Exercise for Health
Benefits of doing exercise
I- Reduces Risk of:
 CHD
 Stroke
 Bowel cancer
 Osteoporosis
 Obesity
 Stress & anxiety
 Mild Depression
II- Increases sense of Well being

How much exercise should I
do?
 At least 30 min of moderate
exercise at least 5 days a week
(most days)
 Three 10 min sessions of activity
at different times in a day.
 Try to increase the amount to 40-
60 min /day
Moderate exercise
 Means that you get warm,

 mildly out of breath,
 mildly sweaty
 Not intense
What sort of Exercise?
 Anything that makes your heart

rate increase,
 Mildly out of breath
e.g,
 Brisk walking
 Jogging
 Swimming
 Cycling
 Dancing
What are Health Benefits of
Exercise?
 Heart disease, hypertension, &
stroke reduced by 1/3 in those
who exercise,
 Helps Heart disease from getting
worse,
 Increases HDL cholesterol,
 Weight Control.
 Prevents Osteoporosis:
By pulling on the bones by the
muscles to stimulate bone
making cells.
 Prevents Cancer:
Decreases the chance to the half
in bowel and breast cancer.
Exercise in Older People
Risks with Exercise:

 Injury, sprains
Could be decreased by warming up

 Stress fractures in Marathon
 Sudden death, if you do not make
exercise, rare if you are used to
moderate exercise
Exercise and heart Disease
 Physical inactivity (Lack of

Exercise) is one of the
independent modifiable risk
factors of CHD.
Benefits of Regular Exercise
 Improves heart and lungs function
 Decreases:
- Resting blood pressure
- Body fat
- Total Cholesterol and LDL
- Risk of bone injury
 Raises:
- HDL
- Energy expenditure
- Tolerance to stress and depression
 Controls Diabetes
Guidelines for Safe Exercise
 Frequency: 3-5 times a week

 Duration: 20-60 minutes
 Intensity (how hard): within
your target heart rate.
Calculating Your Target
Heart Rate
 Maximum Heart Rate (MHR)=
Age – 220
 The Lowest limit of your HR =
MHR × 0.6
 The Upper limit of your HR =
MHR × 0.8
 If your Age is 40 years
 Your MHR = 220-40=180
 The Lowest limit of your HR =
180 × 0.6 =108

 The Upper limit of your HR =
180 × 0.8 =144

 Therefore your target heart rate is
between 108 and 144

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OBESITY

 Is an excess of total body weight

 There is no single established

1. According to number or size of

 It is the ratio of waist

 It is a simple useful three levels

 Is calculated by the following equation:

 Determine that risk to health

 Represents a level at which

Mild 20-40 25-30 90.0%

Moderate 41-100 30.1-35 9.5%

Severe >100 >35 0.5%

 Corpulence index= actual

8- Obesity as a problem in surgery:

 E= Exercises (regular exercise)

 A= Attitude (negative attitude towards

 R= Relationship (social support to loose

 N= Nutrition (lowering caloric intake to less

II- Increases sense of Well being

 Means that you get warm,

 Anything that makes your heart

Risks with Exercise:

Could be decreased by warming up

 Physical inactivity (Lack of

 Frequency: 3-5 times a week

180 × 0.6 =108

180 × 0.8 =144

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