Obesity and weight loss training. Aspects to consider

Obesity and weight loss training. Aspects to consider

Do you have to plan the training of someone who is obese like someone who is slightly overweight or normal? Surely you will say or think “of course not”. Well, it is an easy and simple answer, but do you really know what main differences there must be?

As we already know, the individualization principle is one of the most important training principles. We assume that each individual is unique and therefore needs individualized training adapted to his needs. So far everything is correct, but as a general rule, the population that suffers from obesity usually has a series of handicaps that are usually general among the majority and that any coach should take into account when planning a weight loss training program. (I just remembered the famous Osmin Method program and its training “how individualized and adapted they were”, right?)

What is obesity?

Many think that obesity is having too many extra kilos, accumulation of fat, period. I wish it were so, obesity is not a merely aesthetic problem

It wreaks havoc on the body in many ways. Obesity produces a cascade of sequelae that form a vicious circle:

  • They do not sleep well, therefore, alteration of the circadian cycles guided by sunlight. People who do not sleep well are hungrier at night and for energy foods, to stimulate insulin and sleep.
  • Sarcopenia: Loss of muscle mass due to hypoactivity and all the functional, structural, or endocrine problems that this entails

Atrophied endocrine system:

  • As more fat and less muscle mass, leptin increases, and testosterone and GH hormone decrease. We already know leptin and we know what happens when we secrete too much, we become resistant to it! Therefore, we will secrete more and more leptin, which implies that in turn, we secrete more aromatase in adipose tissue (it converts TST into estradiol, male hormone into a female) and all the problems that this entails since almost all
  • TST converts it into estradiol.
  • Leptin constantly impacting, as we have said before, makes the obese resistant to it and they need more and more leptin. Leptin (satiates hunger) inhibits the neuropeptide NPY (stimulates hunger). Obese people have a lot of blood but it does not reach their target (hypothalamus). By becoming resistant to it, thyroid hormones (TSH) that increase metabolism decrease.
  • Catecholamines, known among other things because they inhibit the appetite signal, are inhibited in the obese.
  • In obese people, adiponectin (anti-inflammatory) levels are low.
  • In obese people, cortisol is high to decrease inflammatory markers. Adipose tissue converts cortisone to cortisol through the enzyme 11B-HSD2, leading to Cushing’s Syndrome. If the person is very stressed, they will have more cortisol, therefore, they shouldn’t train because they will secrete more cortisol. If you are de-stressed, you can train.

So taking this into account and knowing that obesity is a disease and not a merely aesthetic problem, physical activity planning should be prescribed by a professional who knows and takes all of this into account. Broadly speaking, I will give some general recommendations to take into account when prescribing physical activity for obese people, although as I said before, the principle of individualization prevails.

  • Obese people have inhibited beta-oxidation, they find it difficult to use fat as an energy source. They lipolysis (break the TG) and then those free FA remain in the muscle and we use them to burn them, they accumulate in the muscle, in the blood-producing atheromas; with which moderate physical activity is recommended, not at high intensity in aerobic or HIIT (very common to see this in sports centers).
  • Yes, you should do strength training. The obese person uses more energy than a trained person. Strength will increase beta-oxidation (Borg scale), TST, GH, and catecholamines.
  • Moderate resistance training improves GLUT4 translocation to the membrane even more than cardiovascular work, thereby improving the IR of obese patients
  • Mitochondrial biogenesis, improves with aerobic and therefore is also an important part but due to its weight and its low mitochondrial density, it is recommended that it be soft and low impact. Also, its high weight and anatomical dysfunction, together with the low bone density that it may suffer, makes obese people very sensitive to joint injuries such as knees or hips.
  • The obese person has altered biomechanics: spine, tread (plantar fasciitis), internal tibial rotation, cannot squat well, etc. You have to unload the chest (hyperkyphosis), muscle balance, it is difficult for them to breathe, they cannot open the rib cage, thus they have hypoxia. We cannot ask someone who is obese to squat correctly on the first day as their anatomy is out of balance and it will be impossible for them.
  • Do global exercises, 10-15 reps, medium loads, priority to the back, 6-8 circuit exercises, 2-3 min. rest between sets. At the end cardio 10-15 min. low impact, 3 times a week, comfortable exercises, good technique. Aerobic training is not the foundation, it should be, but it does not increase TST or GH.

 

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