Obesity Treatment: The Science Behind Fitness, Versus Weight Loss

Insights into the latest report on obesity treatment in iScience.

More and more, health clubs and gyms are emphasizing the beneficial aspects of gyms beyond weight loss, including those related to mental health and overall quality of life.

A recent report on obesity treatment published in iScience supports this shift, finding that increasing fitness and physical activity were more effective for reducing health risks, over weight loss.

According to researchers Glenn A. Gaesser and Siddhartha S. Angadi, the study supports a weight-neutral strategy for obesity treatment, due to the following findings:

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 like 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.
5. Weight cycling is associated with numerous adverse health outcomes, including increased mortality. 

What does this mean for fitness facilities and how they program for clients with obesity? According to Sabrena Jo, the director of science and research at ACE Fitness, the researchers challenge fitness professionals to think about shifting the primary focus away from losing weight, and instead focus on physical activity to improve fitness.

“So, focusing on all the immediate and long-term benefits of exercise and physical activity — e.g., improved mood, reduced anxiety, improved cardiometabolic health markers, and increased physical fitness and performance — would be areas for clubs to spend resources on promoting and tracking,” said Jo.

In fact, this approach could be beneficial to members across the board — with obesity, and without.

“Although the researchers didn’t discount weight loss, they made it clear that not focusing on it could be an important way to reduce the prevalence of weight cycling — repeatedly losing and then gaining back weight — which has been associated with increased risk of developing sarcopenic obesity, morbidity and mortality. In addition, not focusing on pounds on the scale could be liberating for so many people who have failed time and time again at the very difficult task of losing weight.”

Top Takeaways from the iScience report on obesity treatment, according to Sabrena Jo:

1. First, the risk of dying associated with obesity is largely attenuated by cardiorespiratory fitness.
2. Second, most cardiometabolic risk markers associated with obesity can be improved with exercise training, independent of weight loss.
3. And third, weight loss is not consistently associated with lower mortality risk but increases in fitness and activity are.