In this article, we will look into the training program design for obesity. The definition of obesity varies depending on what one reads, but in general, it is a chronic condition defined by an excess amount body fat. A certain amount of body fat is necessary for storing energy, heat insulation, shock absorption, and other functions (Mark, CPT (Dr) and SWO Johnny Lim, 2008). Table 1 lists out the distribution of obesity population in Singapore.

Physical activity and exercise help burn calories effectively when executed in moderate to high intensity level. The amount of calories burned depends on the type, duration, and intensity of the activity, which also depends on the weight of the person. Taking for instance, a 200-pound person will burn more calories running 2.4km as compared to a 120-pound person, as the amount of work done in carrying those extra 80 pounds must be factored in.

However, exercise as a treatment for obesity is most effective when combined with a diet weight-loss program. Exercise alone without diet will have a limited effect on weight in the long run as one has to exercise a lot to simply lose one pound. Studies show that if you are overweight or obese, losing 5% to 10% of your body weight can improve your overall health. It is best to consult your doctor, nutritionist or dietician for advice.

The ACSM guidelines state that the obese individuals should be encouraged to exercise on most, if not all, days of the week for a minimum of 150min per week. In general, the exercise duration should fall between 40min to 60min each day, and it may be done in either one long bout or divided into two shorter bouts.

It is seldom for obese individual seeking to begin exercise without also setting some goals related to weight loss (although exercises provide benefits even in the absence of weight loss). Setting suitable weight loss goals to lose 0.5kg to 1kg per week is reasonable and achievable. For instance, reducing caloric intake by 500 kcal per day and expending an additional 300 kcal per day would lead to a caloric deficit that would estimated a 0.7kg loss per week (7 x [500+300] = 5600 kcal per week).

On the average, diets with less than 1200kcal per day are not advisable without sacrificing nutritional needs. An appropriate distribution of macronutrients along with the necessary amounts of vitamins and minerals should be incorporated in the dietary planning.

Diets which are low in fat, particularly saturated fat, not only are effective for weight loss but are also associated with long-term weight maintenance. It is suggested that overweight and obese individuals should reduce body weight by at least 5% to 10% so as to gain health benefits such as lower blood pressure and a more favorable blood lipid profile. For some individuals, an even greater reduction in body weight may be optimal for health improvement (Howley, Edward T. and B.Don Franks, 2003).

Some facts also indicated that an even greater caloric expenditure (i.e. > 2000 kcal per week or 200-300min per week) may be most beneficial for long-term weight control. Participants initially may not be able to exercise this long. Therefore, an initial focus of the exercise programming is to build up sufficient endurance to sustain the nature of the aerobic activity so as to reach these duration goals.

The initial exercise intensity may start off with just 40% to 50% of VO2 max, with an eventual goal of sustaining activity between 50% and 70% of VO2 max. A balance between exercise intensity and duration should be used to achieve a target energy expenditure of 300 to 500 kcal each day for those attempting to lose weight.

In the designing of exercise programs for obese individuals, it is important to include some special considerations. One of the primary goals of any exercise program should be safety. Especially for obese individuals, avoiding orthopedic injures is a particular concern due to the additional loading of the body weight to the joints. Hence, low-impact activities (water exercise, cycling, and walking) are more preferable when individuals just begin to exercise regularly. Proper posture alignment is also important in the execution of the exercise to avoid unnecessary wear and tear to the joints and has to be incorporated as part of the functional daily physical activities. Tai Chi provides a good form of exercise for obesity as the movements focus a lot on the proper technique of weight transfer and correct postural alignment. (Yip See Kit, 2007)

After some weight loss and conditioning has been done, individuals may then choose to participate in other higher impact sports and activities. Another safety concern is thermoregulation. Due to the excessive body fatness and the increased energy demands of activity, maintaining the body cool during exercise can be problematic for obese individuals. Thus, individuals should be encouraged to exercise at cool times of the day or in temperature-controlled environments such as air con room. These exercisers should also maintain adequate hydration by drinking lots of water during and after their workout session.

exercise, obesity, weight loss, special population