Exercise alone is, unfortunately, not a terribly effective method for losing weight. It is difficult for the untrained person to do enough of it, and most if not all of the expended energy is compensated by increased caloric intake. Exercise is, however, a superb way to maintain a lower weight after weight loss, enabling a person to eat somewhat more than a nonexerciser and maintain the same given weight. Regular aerobic exercise and strength training will also improve cardiovascular fitness, trim inches, and promote growth of metabolically more active muscle tissue.
An exercise assessment should include a record of the usual degree of physical activity, any limiting factors such as joint disease or previous injuries, types of activity the patient finds enjoyable, and a measurement by an exercise physiologist of the current fitness level. A formal stress test is not required unless cardiovascular disease is suspected.
A rule of thumb in devising an exercise regimen that will be followed is the phased-in approach. Most obese patients start out with a limited capacity to exercise. Rather than suggesting a type of level of activity that is unlikely to inspire adherence, make sure that the plan fits into the patient's schedule and lifestyle.
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