Physical activity and exercise within the context of obesity treatment: Enhancing health beyond weight loss

• Excess weight and adiposity that results in overweight or obesity is associated with significant negative health consequences. • Physical activity is an important public health target for adults with overweight or obesity to provide a wide range of health benefits that extend beyond those of weight loss alone, which can include of fitness, physical function, and enhanced cardiometabolic, brain, cognitive, and psychological health. • While there are independent effects of physical activity on health, some of these benefits are enhanced when physical activity reduces body weight or enhances body composition, and therefore assessing for these effects is of importance. • Physical activity programming for adults with overweight or obesity should be designed by appropriately trained exercise professionals and be progressive, individually tailored to the person, and initially designed to target mobility, physical function, and other health benefits. Overweight and obesity are significant public health concerns worldwide due to their association with many chronic health conditions. This has resulted in the development of various interventions focused on weight loss to reduce the associated health burden. Physical activity is an important lifestyle behavior associated with enhanced health. Evidence supports that many of the benefits of physical activity are realized independent of initial weight status or whether weight loss is achieved, with some benefits additive to what is achieved with weight loss alone. These benefits include enhanced cardiometabolic, brain, cognitive and psychological health, and others. Moreover, in adults with overweight or obesity, physical activity has independent effects on cardiorespiratory fitness, muscular strength, physical function, and mobility. There are also benefits to body composition, with physical activity improving the quality of key tissues, such as skeletal muscle, which may not occur with diet-induced weight loss. Therefore, physical activity is an important public health target for adults with overweight or obesity to provide a wide range of health benefits that extend beyond those of weight loss alone. However, physical activity recommendations and programming efforts should consider the unique characteristics of adults with overweight or obesity to be most effective, and should support a focus on mobility, physical function, and other health outcomes.