Does Physical Activity Help In Weight Management? 2020 Canadian Obesity Guidelines

Many patients I meet describe frustration that they have been ramping up their exercise, but not seeing any results on the scale. Some people also find that they are gaining rather than losing weight, despite their efforts.

So: does exercise actually help to manage overweight or obesity?

The Physical Activity chapter of the 2020 Canadian Adult Obesity Clinical Practice Guidelines provides clarity on this important question.

While exercise itself doesn’t result in much weight loss for most people, exercise is an integral component of all obesity management strategies because it carries many benefits which are partly independent of weight loss, and even present in the absence of weight loss:

Exercise improves metabolic health (blood sugars, insulin resistance, blood pressure, cholesterol) – and remember, weight management is about improving health, not moving numbers on the scale.
Exercise can improve quality of life, depression, anxiety, and body image in adults with overweight or obesity.
Moderate to vigorous aerobic activity can reduce fat in the liver, around the heart, and abdominal visceral fat (around organs) – this is the metabolically dangerous fat that increases the risk of obesity-related health conditions.

What type of exercise, and how much, is recommended?

30-60 minutes of moderate to vigorous aerobic activity most days of the week, which can help with a little weight loss, fat loss (including that dangerous visceral fat), and increase both fitness and mobility. While not a lot of weight is lost with this amount of activity, there is typically more weight loss with higher amounts of activity. Also, this activity IS VERY beneficial to help maintain weight AFTER weight loss, and it is also helpful to maintain lean muscle during weight loss. (note: the definition of ‘moderate to vigorous’ activity will be different for different people. Exercise prescriptions need to be tailored to the individual, considering what they are currently doing, what they find to be moderate to vigorous in effort, and taking into consideration any health issues that may impact type or capacity to exercise.)
Resistance training is recommended (eg weights) at least twice a week to maintain weight and increase muscle mass and mobility in adults with overweight or obesity.
Increasing exercise intensity is recommended (this can include HIIT – high intensity interval training) to give bigger benefits to cardiorespiratory fitness and reduce the amount of time required to get the same benefits as from moderate intensity exercise (but higher intensity exercise does not result in greater weight loss or change in fat mass).

The authors also point out that it is important to consider that physical activity can increase the risk of injury. A higher body mass index (BMI) is associated with higher risk of injury, as well as being injured earlier in a new activity program. Strategies to reduce injury risk can include:

gradually progressing intensity, duration, and frequency of exercise
ensuring proper footwear
fitting of equipment
an exercise professional (eg kinesiologist or exercise specialist) to guide and supervise exercise

NOTE: This blog is not intended to be a full synopsis of the chapter. There is a wealth of information in this chapter that is beyond the scope of one blog post. I encourage everyone to dig in to the entire chapter!

Stay tuned for much more on the Obesity Guidelines in coming weeks!

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