Aerobic and strengthening exercises are foundational components in the management of obesity and related metabolic disorders, such as diabetes mellitus.118–120 There is an ever-growing base of evidence demonstrating the benefits of different exercise programs and modalities on energy expenditure, weight loss, and reductions in adiposity.121
A wide variety of aerobic training interventions and modalities are available, including interval, high-intensity interval, land-based and aquatic, accumulated bouts or sustained activity, and each confers different type of metabolic adaptation.122,123 Advanced training program will expand the use of exercise medicine into routine care and prepare physicians to interpret exercise adaptations and health outcomes in obesity in the context of current medication use, while preserving skeletal muscle mass, enhancing fat oxidation, and controlling blood glucose.
As obesity remains highly prevalent in the U.S., affecting about 40% of adults, with severe obesity rising, and a record 21% of children and adolescents,194,195 EMD&T-trained physicians will be well-equipped to perform exercise testing and develop evidence-based, customized prescriptions for safe weight loss, with the individual patient comorbid conditions, physical limitations, preferences, and resources in mind.