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Wyatt H. Obesity & Lifestyle. Presented at: Cardiometabolic Health Congress; Oct. 21-24, 2020 (virtual meeting).
Wyatt reports she receives royalties as a book author from Rodale for the book State of Slim, is the owner of Shakabuku LLC and Dr. Holly LLC, owns a patent for Energy Gap, has been a consultant for The Beef Checkoff, has served on the advisory boards for Gelesis and Roman Healthcare and has received research support from Gelesis, the National Cattleman’s Association and Novo Nordisk.
Providers should focus on the volume of physical activity performed by individuals with obesity and motivate them to get the most success in maintaining weight loss, according to a speaker at the virtual Cardiometabolic Health Congress.
“This is where that lifestyle medicine comes in that we need to be good at,” Holly Wyatt, MD, professor and vice chair of clinical programs in the department of nutrition sciences at the University of Alabama Birmingham, said during a presentation. “Really thinking about, how do you help [patients] change their environment to get that physical activity in? How do they put routines in place to get that physical activity in? How do you motivate your patient? How do you help them motivate themselves? How do you hook their purpose, their lives, something that’s super important to them, to the behavior of increasing physical activity?”
Wyatt said a large emphasis needs to be placed on physical activity because it is the driver for long-term success of weight loss. During weight loss, individuals see a drop in energy expenditure from a reduction in body weight. Wyatt said the energy gap can be filled through more physical activity.
The biggest factor providers should focus on in physical activity is volume. Wyatt noted the amount of physical activity needed to maintain weight loss is different than the amount needed to lose weight. According to the National Weight Control Registry, individuals looking to maintain weight loss should partake in 60 minutes or more of moderate-intensity exercise or 35 or more minutes of vigorous activity per day. The American College of Sports Medicine recommends between 200 to 300 of moderate activity per week, with a greater amount of exercise leading to better results.
“About 150 minutes you get health benefits, but 300 minutes a week is really the volume that we think you need to be able to maintain weight loss,” Wyatt said.
Providers should use volume as the base for any physical activity plan, she said, noting that after establishing this, other factors can be considered, including the sustainability of a physical activity plan, intensity, timing and variety.
Providers should be aware that individuals with obesity may not be familiar with exercise and are at an increased risk for musculoskeletal injuries. Wyatt said each patient’s abilities, activity preference and response should be considered when creating a plan. However, she added, physical activity has the potential to do way more good than harm when it comes to weight loss maintenance and overall well-being.
For individuals who say they cannot exercise, Wyatt encouraged providers to get creative and motivate their patients to do a simple activity such as walking in place. Providers can implore individuals to re-engineer their environment and decrease sedentary activities by walking while on the phone or moving while watching television.
“If you can’t motivate your patients, if you can’t help them see the reason why they should do it, get to their own internal motivation, then you’re not going to be very successful at helping them get where they need to be with the physical activity,” Wyatt said.