Lifestyle modification for weight loss: Effects on cardiorespiratory capacity in patients with class II and class III obesity

Abstract

Background:The prevalence of obesity has increased worldwide. Obesity affects the lungs and airways, limits peak oxygen uptake, and hampers physical performance; however, objective data are scarce. Does lifestyle modification for weight loss (LM) have an impact on cardiorespiratory capacity (CRC) in patients with class II and class III obesity?Method: This was a single-center prospective 2-year follow-up pilot study. Four separated stays in the inpatient specialized medical center Muritunet with an integrated approach to LM, including an individual plan on diet and physical activity (PA) goals. Furthermore, it included lectures and counseling on human anatomy and physiology, nutrition, physical exercise, and motivation, as well as daily PA.Cardiopulmonary and blood chemistry tests were conducted.Results: Seventy-seven participants were included; however, 47% (n = 36) dropped out during follow-up. Forty-one participants completed the study. At baseline (BL), the mean age was 45.4 (SD 10.2, range 23-62) years, with a mean body mass index (BMI) of 41.3 (SD 5.4) kg/m 2 , and 85% (n = 35) had one or more comorbidities, such as obstructive pulmonary disease (n = 15, 37%), obstructive sleep apnea (n = 19, 46%), type 2 diabetes (n = 20, 49%), and hypertension (n = 17, 41%). The mean functional residual capacity increased, significantly the second year (p = 0,037). CRC increased significantly the first year (p = 0.032). Weight and BMI declined, reaching statistical significance at 2 years for both males and females (p = 0.033 and p = 0.003, respectively). At BL, the participants reported lower health-related quality of life compared to the general Norwegian population. Across time the physical component summary score (quality of life) for both males and females (p = 0.011 and p = 0.049, respectively) increased significantly. Conclusion:Lifestyle modification for weight loss improves CRC in patients with class II and class III obesity.

Improvements in cardiorespiratory fitness, muscle strength and body composition to modest weight loss are similar in those with adult‐ versus childhood‐onset obesity

“…The literature suggests that an increase of 1–2 MET (3.5 mL kg −1 min −1 ) in CRF is associated with a 10%–30% reduced mortality and lower risks of adverse cardiovascular events in adults 32,33 . In adults with obesity, a modest improvement in CRF is associated with improved health outcomes independent of weight and BMI 34 . In addition, metabolic risk factors and all‐cause mortality are reduced as FM and VAT decrease 35,36 .…”

“…32,33 In adults with obesity, a modest improvement in CRF is associated with improved health outcomes independent of weight and BMI. 34 In addition, metabolic risk factors and all-cause mortality are reduced as FM and VAT decrease. 35,36 In the present study, participants with childhood-onset or adult-onset obesity improved CRF predicted by the YMCA and 20MSR on average by 2.5 and 1.6 mL kg À1 min À1 , respectively.…”

Beyond bariatric surgery and weight loss medicaments. A systematic review of the current practice in obesity rehabilitative inpatient programs in adults and pediatrics

“…Lifestyle intervention is agreed to be the only sustainable intervention that could be continued lifelong and should be addressed especially in the early stages of private or public health care preferably by a multidisciplinary team comprised of several figures such as physicians, medical doctors, nutrition specialists, and psychologists ( 4 ). Nevertheless, in most national and international guidelines, a difference between outpatient and inpatient lifestyle interventions is frequently overlooked and nutritional rehabilitation in inpatient settings is only provided when obese people are already hospitalized for chronic or post-acute illnesses, even if obesity is not the main cause ( 8 , 9 ). However, the level of agreement among evidence-based guidelines on how to best manage inpatient weight loss rehabilitation programs is completely unclear.…”