[Physical Activity and Obesity - Underlying Mechanisms, Practical Actions].

Area of Science:

• Exercise Physiology
• Metabolic Health
• Skeletal Muscle Biology

Background:

• Obesity treatments effectively reduce weight and cardiometabolic risk, but often overlook the concurrent risk of sarcopenia.
• Sarcopenic obesity and sarcopenia independently elevate the risk of cardiometabolic diseases.
• Skeletal muscle acts as an endocrine organ, releasing myokines that counteract sarcopenic obesity.

Purpose of the Study:

• To highlight the risk of sarcopenia associated with significant weight loss.
• To emphasize the role of physical activity and myokine production in mitigating sarcopenic obesity.
• To propose a phased approach to physical activity for sustainable cardiometabolic risk reduction.

Main Methods:

• Review of the physiological mechanisms linking obesity, weight loss, sarcopenia, and cardiometabolic disease.
• Emphasis on the role of skeletal muscle-derived myokines.
• Proposal of a two-phase physical activity strategy (preparatory and weight loss phases).

Main Results:

• Significant weight loss, while beneficial for obesity, can induce sarcopenia.
• Skeletal muscle myokine production, stimulated by physical activity, counteracts sarcopenic obesity.
• Combined endurance and strength training is effective for initiating myokine production.

Conclusions:

• A structured physical activity program is crucial for managing sarcopenic obesity and its cardiometabolic complications.
• Dividing physical activity into preparatory and weight loss phases optimizes sustainable cardiometabolic risk reduction.
• Understanding skeletal muscle's endocrine function is key to combating obesity-related diseases.