PHYSICAL ACTIVITY PROGRAMMING FOR CLIENTS WITH OBESITY: Considerations for Exercise Professionals

Copyright © 2016 American C lthough the prevalence of obesity in North America has plateaued, the proportion of adults living with obesity (body mass index [BMI] ≥ 30 kg/m) 2 A severe obesity (BMI ≥ 40 kg/m ) remains high (46). It is well documented that regular physical activity (PA) is an important habit to prevent unhealthy weight gain and various conditions such as Type 2 diabetes, hypertension, and cardiovascular disease. Importantly, the cardioprotective effects of PA are so potent that habitual PA has been shown to significantly attenuate the risk of mortality and morbidity irrespective of weight and blood pressure status (14,28,43). Given that PA confers innumerable health benefits, improving long-term adoption of regular PA, rather than weight loss, should be at the forefront of health promotion, clinical practice, and policy. So much so that renowned exercise scientist, Dr. Steven Blair, noted in his 2004 editorial in The Journal of the American Medical Association that “the ‘fitness vs. fatness’ debate [is] largely academic” and went on to urge “physicians, researchers, and policymakers [to] spend less energy debating the relative health importance of fitness and obesity andmore time focusing on how to get sedentary individuals to become active” (3). Current data on PA habits of North Americans point to an unfortunate reality: most adults do not meet the recommended PA guidelines of 150 minutes of moderate-to-vigorous PA per week minimum (8,19,48). Moreover, individuals living with obesity are less likely to meet PA guidelines compared with individuals in lower weight categories (8,48). Physical inactivity among individuals with obesity is a complex and poorly understood phenomenon. A growing body of evidence suggests that societal antifat attitudes are negatively impacting the uptake of PA-promoting behaviors among adults. Media and cultural misrepresentations of this multifactorial phenotype on reality television shows, such as “The Biggest Loser,”may partially be responsible for cultivating the characterization that people with larger bodies are unhealthy, lazy, and lacking self-discipline (55). Portraying obesity