DeutschAt Erdem Hospital, physical activity stands as a cornerstone of our obesity treatment model, alongside nutritional plans, behavioral therapy, and medical solutions. When it comes to managing obesity, movement and exercise are always part of the conversation — and for good reason. Physical activity helps the body use energy more efficiently, whereas a sedentary lifestyle is a major contributor to weight gain, potentially even more impactful than excessive caloric intake.
Nonetheless, advising patients to simply “exercise more” oversimplifies the reality many individuals face. People living with obesity often encounter real obstacles when it comes to being active. To offer meaningful support, it’s essential to grasp these hurdles and present realistic, safe ways to become more physically active. This article dives into common barriers and how we might overcome them to improve health outcomes.
How Exercise and Obesity Are Connected
Most adults in the U.S. fall short of the 150 minutes of moderate physical activity that the CDC suggests. But for people dealing with obesity, the American College of Sports Medicine points out that even more may be needed — up to 250 minutes weekly. Unfortunately, it’s not as simple as telling someone to take more walks.
According to a 2018 advisory report on physical activity, more frequent and intense activity (especially moderate to vigorous levels) tends to reduce weight gain. When combined with a calorie-restricted eating plan, exercise doesn’t just add to weight loss — it can boost it by roughly 20%.
Sustained weight loss and prevention of regaining weight are most often seen when individuals engage in 200–300 minutes of exercise per week, or expend 2000+ kcal through leisure activity. Beyond shedding weight, consistent physical activity can enhance:
- Hormonal and immune functions related to fat tissue, such as better insulin response
- Cardiovascular, muscular, respiratory, and mental health
- Metabolism, muscle-to-fat ratio, and baseline calorie burning
It’s also important to look beyond structured exercise to include everyday physical activities — or what’s known as NEAT (non-exercise activity thermogenesis). This includes everything from walking to doing chores, and it can have a powerful effect on overall wellness.
Excess body fat increases the risk of cardiovascular issues such as atherosclerosis. But exercise, especially aerobic activity, reduces fat and helps lower these risks. It also addresses conditions like insulin resistance, chronic inflammation, and poor blood lipids — all factors linked to heart disease and metabolic syndrome.
What the Guidelines Say About Physical Activity
The baseline recommendation for health-promoting activity is 150 minutes per week, but there’s flexibility in how people meet that goal. For example:
- 150–300 minutes of moderate aerobic activity (like brisk walking, water aerobics, dancing, or volleyball)
- 75–100 minutes of intense aerobic workouts (such as running, competitive sports, or intense fitness classes)
Some activities, like swimming or cycling, can be dialed up or down in intensity to suit individual fitness levels.
Top Exercise Options for Obesity Management
When it comes to weight control and general wellness, a varied approach that mixes aerobic and anaerobic exercises is ideal. There is no one-size-fits-all method — the key is aligning activity with individual preferences and needs. This is where the FITT framework becomes useful.
Studies show that the type of activity matters less than the amount — as long as it’s enough to impact energy balance. People who struggle with weight-bearing activities should consider low-impact alternatives to reduce joint stress while still getting results.
Aerobic Training
Aerobic activities get the heart pumping and raise your breathing rate. Whether it’s power walking, dancing, swimming, or an active sport, these movements help burn calories and build stamina. A typical session starts with a warm-up, builds to a full-intensity phase, and finishes with a cool-down.
Strength and Resistance Work
Anaerobic training may not always be front of mind for those aiming to lose weight, but it plays a vital role. Resistance exercises can raise your resting metabolism and help manage conditions like type 2 diabetes. The ACSM recommends at least two resistance workouts each week. Strengthening muscles helps maintain lean mass, protect joints, and improve posture — all crucial for long-term health.
Flexibility and Balance
Too often, flexibility and balance training are skipped. But stretching and coordination exercises help prevent injuries, increase range of motion, and make everyday movement easier. Activities that emphasize balance — like dance or paddle sports — open up more possibilities for physical activity and can be surprisingly enjoyable.
High-Intensity Interval Training (HIIT)
HIIT alternates bursts of high-effort movement with rest periods. These short, intense workouts can involve cardio or strength work. While research supports HIIT as effective, particularly for increasing fat burning, recent findings from ACSM indicate it’s not necessarily better than traditional moderate-to-vigorous workouts. However, it’s a viable and engaging option for many.
If someone can’t manage moderate or vigorous routines, lighter activity — done for longer periods — can still contribute meaningfully to calorie burn and overall health.
Medical Assessment Before Starting Exercise
Before beginning a new workout routine, individuals with obesity should undergo a full medical check. Assess cardiovascular, respiratory, and musculoskeletal health, as well as physical limitations. Don’t assume inactivity based on body size — tools like the PAR-Q or PAR-Q+ can help guide the screening process.
Some medications, especially for blood pressure or diabetes, may need to be adjusted as activity levels increase.
Creating an Exercise Plan and Monitoring Progress
Doctors’ advice can significantly influence how well patients stick with exercise. Many people benefit from a structured plan — especially when it includes support and accountability.
Use the FITT method (Frequency, Intensity, Time, and Type) to shape exercise prescriptions. Other versions like FITTE (adding Enjoyment) or FITT-VP (adding Volume and Progression) may work better for different individuals.
Example prescription:
- Frequency: 5 times per week
- Intensity: Moderate
- Time: 30 minutes each session
- Type: Walking briskly
- Volume: Track distance walked
- Progression: Start at 10 minutes and add 5 minutes monthly
To maintain motivation and monitor results, individuals can log their workouts in journals, use wearable trackers, measure physical performance, or track body composition metrics.
Common Barriers and How to Overcome Them
A successful conversation about weight and movement starts with empathy. Listening to patients’ concerns is key to helping them find realistic and enjoyable ways to be active.
“Exercise Feels Unpleasant”
The word “exercise” can feel burdensome. That’s why using the broader term “physical activity” — which includes things like walking the dog or gardening — can lower resistance. Even short bouts of activity throughout the day can add up. Walking, in particular, is a highly accessible option that helps with weight control and cardiovascular health, even if it’s not the most efficient weight loss method alone.
People are more likely to continue activities they enjoy — like dance, biking, or recreational sports — rather than those they see as chores.
“I’m Embarrassed to Exercise in Public”
Feeling judged is a common concern. Suggest private workouts at home, walks with friends, or group classes in supportive environments. Building confidence is as important as building fitness. For some, working with a therapist may help address negative self-perceptions and foster a healthier mindset.
“Exercise Makes Me Feel Hungrier”
Burning more calories can trigger stronger hunger cues. This is the body’s natural way of defending its weight set point. Overeating in response can negate the benefits of exercise. Encourage balanced eating with enough protein and healthy fats to reduce cravings. Help individuals distinguish between true hunger and emotional eating or habitual cravings.
“I’m Worried About Injury”
Carrying extra weight can strain joints and increase the risk of injuries. That’s why a gradual start, proper technique, and low-impact activities like water aerobics or stationary cycling are ideal. For those with significant weight to lose, seated workouts can be a great first step. Include plenty of rest, gentle stretching, and proper nutrition to prevent setbacks.
“I Can’t Stay Consistent”
Sticking with a routine is often the biggest hurdle. Consistency matters more than intensity. Encourage patients to explore enjoyable activities, use tracking tools, and find accountability partners. Even irregular routines are better than none — and physical activity is a powerful counterweight to fluctuations in diet, stress, and sleep.
Putting Obesity and Exercise into Context
While physical activity is vital, it’s only one part of a four-pillar strategy. Not every patient will respond the same way, and the approach must be tailored to the individual. Still, movement benefits nearly everyone, no matter where they are in their journey. Managing obesity requires commitment, and regular activity remains one of the most effective tools we have for both reducing weight and improving long-term health.