A successful long-term weight loss program consists of diet, physical activity and behaviour modification. For decades, regular exercise has been recognized as a cornerstone of weight control, along with diet and medications.

In fact, in addition to its important role in weight management for obese and diabetic patients, there is irrefutable evidence of the effectiveness of regular exercise in the treatment and prevention of other chronic diseases such as cardiovascular disorders, cancer, high blood pressure, depression and osteoporosis. 

Unhealthy lifestyles, such as lack of physical exercise and improper diet, initiate and spread weight gain due to unbalanced food intake and energy expenditure. Physical activity is a central part of lifestyle modification that can prevent obesity or type 2 diabetes.

The role of physical exercise in weight loss programs.
The role of physical exercise in weight loss programs
Obesity/overweight is an extremely frequent problem that is associated with a range of potential health risks.

Exercise intervention has been included by several weight loss programs by health professionals in an effort to combat the increasing prevalence of obesity.

Although diet is important in the initial stage of weight loss, the incorporation of physical exercise as part of a weight-loss plan helps maintain weight loss and prevent long-term weight recycling syndrome.

It has been confirmed that exercise is beneficial for weight loss and glycemic control in people with type 2 diabetes.

Regular physical activity can improve insulin action through changes in regional adipose tissue (specialized connective tissue used as the main storage site for triglyceride fat), which is a recognized indicator of risk of type 2 diabetes and cardiovascular disease, and more recent research suggests that intramuscular lipids are a preliminary contributor to the pathogenesis of resistance to insulin.

As the most variable part of energy expenditure, regular physical exercise can help control the development of obesity and contribute to success in short and long term weight loss.

In people with obesity, exercise can be predominantly essential to maintain initial weight loss by increasing total energy expenditure, preserving lean body mass and producing modifications in substrate utilization.

In addition, the psychological benefits derived from regular participation in a physical program can serve as an additional driving force to participate in such long-term activities.

Resistance or aerobic training can only improve glycemic control and achieve weight loss in type 2 diabetes, but the improvements are more noticeable with combined resistance and aerobic training.

Structured aerobic training (fast walking, jogging or cycling) or resistance training (weightlifting) decreased the absolute value of haemoglobin A1c (glycosylated haemoglobin) by approximately 0.6%.

The haemoglobin A1c value shows the average plasma glucose concentration during the previous two or three months. Higher HbA1c levels can be found in patients with constantly elevated blood sugar levels, such as diabetes mellitus.

Persistent elevations of HbA1c increase the risk factors for vascular complications of diabetes, such as heart attack, coronary heart disease, stroke, kidney failure, heart failure, erectile dysfunction, neuropathy, gangrene and gastroparesis. These investigations indicate that physical activity should be a pillar of weight control and primary diabetes prevention.

Resistance exercise can stimulate beneficial changes in insulin sensitivity through the development of muscle mass, promoting the elimination of glucose from the circulation, effectively increasing glucose storage and decreasing the amount of insulin necessary for the maintenance of a normal glucose tolerance. 

Due to the health benefits of resistance exercise, experts recommend that resistance training be included in various fitness programs, in particular, weight loss programs. People with type 2 diabetes are recommended to do resistance training three times a week.

However, physical activity alone, without concomitant control of diet and lifestyle modification, is not enough to produce a noticeable weight loss. Because the obese patient often has trouble performing enough exercise to create enough energy expenditure.

In addition, for people in this group, it is very possible to counteract the increase in energy consumption through physical training through increased food intake or by inactivating when they do not participate in exercise programs.

In addition, there is controversy over whether aerobic and/or resistance exercise has the same effect on weight loss compared to caloric restriction in the diet.

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