@article{ddaf7c6ff813400fa05589fff23f26c8,
title = "Obesity treatment: Weight loss versus increasing fitness and physical activity for reducing health risks",
abstract = "We propose a weight-neutral strategy for obesity treatment on the following grounds: (1) the mortality risk associated with obesity is largely attenuated or eliminated by moderate-to-high levels of cardiorespiratory fitness (CRF) or physical activity (PA), (2) most cardiometabolic risk markers associated with obesity can be improved with exercise training independent of weight loss and by a magnitude similar to that observed with weight-loss programs, (3) weight loss, even if intentional, is not consistently associated with lower mortality risk, (4) increases in CRF or PA are consistently associated with greater reductions in mortality risk than is intentional weight loss, and (5) weight cycling is associated with numerous adverse health outcomes including increased mortality. Adherence to PA may improve if health care professionals consider PA and CRF as essential vital signs and consistently emphasize to their patients the myriad benefits of PA and CRF in the absence of weight loss.",
keywords = "Nutrition, Obesity medicine, Physical activity",
author = "Gaesser, {Glenn A.} and Angadi, {Siddhartha S.}",
note = "Funding Information: A weight-neutral approach to treating obesity-related health conditions may be as, or more, effective than a weight-loss-centered approach, and could avoid pitfalls associated with repeated weight loss failure (Bacon and Aphramor, 2011, Brown and Kuk, 2015; Gaesser et al., 2011, 2015, Ross et al., 2015). Table 1 summarizes the major points in support of a weight-neutral strategy for obesity treatment, which focuses on increasing PA and improving CRF. Such an approach does not assume that obesity is entirely benign, or that there are not circumstances that may necessitate weight loss (Guo and Garvey, 2017; Guo et al., 2014; Jensen et al., 2014; Kuk et al., 2011; Kushner, 2018; Kushner and Ryan, 2014; Sharma and Kushner, 2009). However, many obesity-related health conditions are more likely attributable to low PA and CRF rather than obesity per se. Epidemiological studies show that CRF and PA significantly attenuate, and sometimes eliminate, the increased mortality risk associated with obesity. More importantly, increasing PA or CRF is consistently associated with greater reduction in risk of all-cause and CVD mortality than intentional weight loss. In addition, improvements in major cardiometabolic risk markers with exercise training are comparable to those associated with weight loss typically achieved by caloric restriction. Publisher Copyright: {\textcopyright} 2021 The Author(s)",
year = "2021",
month = oct,
day = "22",
doi = "10.1016/j.isci.2021.102995",
language = "English (US)",
volume = "24",
journal = "iScience",
issn = "2589-0042",
publisher = "Elsevier Inc.",
number = "10",
}