Article 44: The Neuroendocrine Effects of Exercise for Weight Loss and Exercise Prescription Development

Physical exercise can affect the nervous and endocrine systems, increasing their excitability. Increased levels of adrenaline and noradrenaline can enhance lipoprotein lipase activity, promoting fat breakdown and utilization. Increased free fatty acids reduce cholesterol, triglycerides, and other lipids, decreasing their deposition in parenchymal organs. During exercise, insulin secretion decreases, reducing the conversion of glucose to fat and glycogen, promoting fat breakdown, and reducing fat formation.

Exercise leaves people feeling refreshed and relieves various forms of mental tension. Biochemical analysis shows that exercise can produce a calming effect, reducing the mental stress of restricting diets for obese individuals. Exercise can also lower blood pressure, improve cardiopulmonary function, and help obese individuals develop healthy lifestyle habits.

Even if obese individuals have normal glucose tolerance, they still exhibit insulin resistance, leading to the progression of hypertension, hyperlipidemia, and atherosclerosis. Long-term moderate exercise can enhance the activity of enzymes in adipocytes, accelerate fat breakdown and metabolism, and consume excess adipose tissue, thus promoting weight loss. This, in turn, increases the sensitivity of insulin receptors on adipocyte membranes, achieving blood sugar and lipid-lowering effects.

When obese individuals first begin exercising, their cardiovascular and respiratory systems are weakened, making it difficult for them to quickly adapt to the intensity of the exercise. This can lead to symptoms such as palpitations, shortness of breath, and worsening breathing difficulties, causing them to develop a fear of exercise. Therefore, obese individuals should have a preparation period of at least 10 days before starting exercise therapy.

During this period, you can do some breathing exercises, such as medical gymnastics, starting with simple ones and gradually increasing in difficulty, for 15 minutes each time. You can also do slow to moderate walking for 15 minutes each time, depending on your own pace. After gradually adapting to physical activity, you can then begin weight loss exercises.

Obese individuals should choose suitable exercise programs based on their interests, existing exercise experience, degree of obesity, physical condition, living environment, and age in order to persevere and achieve better results with less effort.

(1) Safety. The intensity or load of exercise should be determined based on the degree of obesity, health status and cardiopulmonary function. Different treatments should be given to different individuals. In general, exercise should be carried out without harming physical health or affecting the growth and development of children and adolescents. Aerobic exercise should be the main focus.

(2) Acceptability. The exercise method should be interesting to the exerciser and enable them to persist in exercising for a long time. In particular, children are psychologically characterized by strong curiosity and poor patience, so the exercise methods, content, and routes should be constantly varied. It is best to follow nature and let them enjoy themselves, and it is important to avoid using adult standards to judge children. The cost should be low and affordable for most families.

(3) Expected results. After exercise, weight and body fat should decrease to a certain level, cardiopulmonary function and physical health should improve, and the degree of obesity should not rebound to the original level within 3 to 6 months after stopping exercise.

(1) Sports activities: Sports that mainly involve moving the body are recommended, such as long-distance running, walking, swimming, playing football, skipping rope, relay races, cycling, and recreational competitions. Those with the means can exercise on indoor treadmills or exercise boards.

(2) Exercise intensity: Due to their excessive weight and poor cardiopulmonary function, obese children should not exercise too intensely. Using heart rate as the standard, the exercise intensity should reach 60% to 70% of the individual's maximum heart rate. The heart rate can be slightly lower at the beginning of exercise, such as 100 to 110 beats/minute. Using oxygen consumption as the indicator, the aerobic exercise intensity should generally be 50% to 60% of the individual's maximum oxygen consumption.

(3) Exercise frequency: For obese children to lose weight through exercise, the first goal is to reduce the current body fat; the second is to cultivate a good habit of long-term exercise so that they can reach their ideal weight in adulthood. An appropriate exercise frequency can prevent obese children from developing an aversion or fear of exercise and stopping their exercise. Generally, it is advisable to exercise 3 to 4 times a week.

(4) Exercise duration: The duration of exercise should be arranged according to the degree of obesity, expected weight loss requirements, and feasible exercise intensity and frequency, ranging from several months to several years. Each exercise session should last no less than 30 minutes. There should be a 10-15 minute warm-up before exercise and a 5-10 minute cool-down after exercise. In addition, the timing of exercise is also important. Due to the periodic changes in the body's biological rhythms, the same amount of exercise will burn 20% more energy in the afternoon and evening than in the morning. Therefore, exercising 2 hours before dinner is more effective in reducing fat than exercising at other times.

Compared to obese children and middle-aged and elderly people, obese young people have better physical strength and greater tolerance for fatigue, so the intensity and amount of exercise can be appropriately increased.

(1) Sports activities: long-distance running, walking, swimming, rowing, mountain climbing, etc. You can also practice aerobic gymnastics, such as aerobics, disco and ball sports.

(2) Exercise intensity: Generally, exercise intensity can reach 60% to 70% of one's maximum oxygen uptake or 70% to 80% of the maximum heart rate.

(3) Exercise frequency: Since young obese people often have a strong desire to lose weight and are more self-aware, the exercise frequency can be appropriately increased in order to improve the weight loss effect. Generally, it is advisable to exercise 4 to 5 times a week.

(4) Exercise time: Each exercise session should last no less than 1 hour, and the duration can be determined according to the weight loss requirements. It is best to exercise 2 hours before dinner.

As people reach middle age, they are often busy with family and work matters, have many social engagements, and their physical activity naturally decreases, leading to weight gain. Therefore, it is even more important for middle-aged people to pay attention to preventing obesity. Overweight or obese individuals should start exercising and losing weight as early as possible to avoid the adverse consequences of obesity.

How can middle-aged people lose weight through exercise? First, they should choose exercise methods and programs based on their physical condition and preferences. They should first have a medical check-up to understand their heart, brain, and lung function before choosing appropriate weight-loss exercises. For middle-aged people, aerobic exercise is the best choice.

Secondly, perseverance is key. Middle-aged people generally have heavy household chores and busy work schedules, but to lose weight, they must be determined to persist in exercise, establish a routine, and set aside 30 minutes each day for weight loss exercises. If they persist for several months, they will definitely see results.

Third, during weight loss exercises, it's important to control the amount of exercise according to your own physical condition, and it's best to proceed gradually rather than rushing. Pay attention to changes in your pulse, heart rate, and blood pressure during exercise to prevent accidental injury.

As people age, the functions of various organs decline, especially for obese individuals. In particular, some obese middle-aged people often have various comorbidities, so safety should be taken into account when developing exercise prescriptions for middle-aged people.

(1) Sports activities: long-distance walking or hiking, jogging, cycling, swimming, mountain climbing, etc., supplemented by Tai Chi, table tennis, badminton, tennis, disco aerobics, etc.

(2) Exercise intensity: The heart rate during exercise should be 60% to 70% of one's maximum heart rate, which is approximately equivalent to 50% to 60% of maximum oxygen uptake. Generally, the heart rate should be controlled at 140 beats/min for 40-year-olds, 130 beats/min for 50-year-olds, and no more than 120 beats/min for those over 60 years old.

(3) Exercise frequency: Middle-aged and elderly people, especially the elderly, have a lower metabolic rate and a longer recovery time after fatigue. Therefore, the exercise frequency can be increased or decreased as appropriate, generally 3 to 4 times a week is appropriate.

(4) Exercise time: Each exercise session should be controlled to 30-40 minutes, with afternoon exercise being the best. In order to improve physical fitness and health, middle-aged and elderly people should cultivate the good habit of exercising throughout their lives.

For the above-mentioned weight loss exercise prescriptions for different age groups, the weight loss effect will be better if they are combined with appropriate dieting (except for children).

Life lies in movement. The purpose of exercise is to improve health and strengthen the body. For obese individuals, regular exercise can help them lose weight, reduce disease, maintain work efficiency, and is also the best way to combat aging.

From a biological perspective, humans have various abilities to maintain a youthful appearance than their actual age. Maintaining the physical strength of a 40-year-old for 20 years is valuable, and even starting to exercise after the age of 60 can yield excellent results.

Reports indicate that elderly individuals aged 60-70 who consistently exercised for eight weeks experienced significant changes and improvements in their circulatory and metabolic systems. In addition to improvements in the function of the heart, blood circulation, and respiratory system, obese individuals also experienced a decrease in systolic blood pressure, a reduction in blood lipids, and substantial improvements in muscle coordination, flexibility, strength, speed, and endurance.

Older adults have many physiological characteristics, including degenerative changes in all joints and slower movements. Therefore, they should choose activities that involve all joints and muscle groups, such as gymnastics, walking, jogging, swimming, Tai Chi, and health massage. These activities should be rhythmic and avoid strenuous activities that are too intense or fast-paced. Activities like Yangko dancing and disco are also beneficial for the health of older adults.

For obese elderly people, the amount of exercise should be determined primarily by their own experience. If they feel warm all over and sweat slightly during exercise, and feel relaxed, comfortable, have an increased appetite, and sleep better than before after exercise, it indicates that the amount of exercise is appropriate and effective.

If you experience dizziness, chest tightness, rapid heartbeat, shortness of breath, decreased appetite, poor sleep, or fatigue during exercise, it indicates that the exercise intensity is too high and should be reduced. If your pulse does not increase and you do not feel warm during exercise, it indicates that the exercise intensity is too low and should be increased. In short, the amount of exercise varies from person to person and there is no need to force a uniform approach; the standard is to achieve your goal.

Because obese elderly people differ from those of normal weight and from other obese adults in many ways, they should make appropriate preparations before engaging in exercise.

① It is best to have a thorough physical examination before exercising to check for any diseases of vital organs. If necessary, exercise should be carried out under the guidance of a doctor. Those who are generally in good physical condition and have no history of chronic diseases can also perform self-examinations. For example, if you do 10-20 squats in a row or run in place for 15 minutes and do not experience shortness of breath or chest discomfort, you can start exercising.

② Elderly people should generally not exercise alone. They should be accompanied by someone or have an exercise partner who is familiar with their health condition. They should carry a first-aid kit or have first-aid medicines and a health record card with them so that they can quickly understand their condition and administer medication in a timely and accurate manner in case of an emergency.

③ Exercise should be gradual. Warm-up exercises are essential before starting any workout. The amount of exercise should be determined based on your physical condition, prior exercise experience, and the intensity of your workout. Movements should progress from slow to fast, from easy to difficult, from simple to complex, from stillness to movement, and then back to stillness. The duration should be gradually increased; do not rush. Excessive exercise has led to numerous cases of elderly people dying as a result.