Part 5: Exercise Therapy: Life Lies in Movement and the Mechanism of Exercise for Weight Loss

III. Exercise Therapy

The causes of simple obesity are twofold: overeating and lack of physical activity. The second treatment targeting these causes is "movement," specifically exercise therapy. Over the past two decades, with the development of preventive medicine, exercise physiology, and geriatrics, more and more people are using physical exercise to treat various diseases. People's understanding of the medical importance of exercise has deepened, and in-depth research has been conducted on the physiology of exercise, the types of exercise, and the selection of exercise intensity. Regarding obesity, some studies have shown the effect of physical exercise on fat: in obese individuals, fat cells can weigh up to 1.5 micrograms, which can be reduced to 0.7 micrograms through diet control alone, and further reduced to 0.3-0.5 micrograms through physical exercise. Because exercise increases calorie expenditure and promotes weight loss, it is an indispensable means of preventing and treating obesity. Current domestic and international data all recommend using diet control as the primary method, combined with exercise therapy, to prevent and treat obesity. The following is an introduction to exercise therapy for treating obesity.

1. The Importance of Exercise

Life lies in movement, and movement is the source of health. This applies not only to humans but also to animals. For example, wild rabbits live an average of 15 years, while domestic rabbits only live 4-6 years. Mongolian hunting dogs can live 27 years, while ordinary dogs only live 13 years. African wild elephants can live 200 years, while domesticated elephants captured in captivity only live about 80 years. The lifespan of wild animals is much longer than that of domesticated animals because they must engage in vigorous activity to compete for survival. Ancient my country recognized this long ago. The Erqinxi (Two Animal Frolics) originated in the Spring and Autumn Period. By the end of the Eastern Han Dynasty, Hua Tuo created the Wuqinxi (Five Animal Frolics), and later martial arts such as Baduanjin (Eight Pieces of Brocade), Tai Chi, and Shaolin Kung Fu emerged. These are all methods for exercising and improving health. Yan Xizhai of the Ming Dynasty aptly stated in his "Records of Words and Deeds": "Nothing is better for nourishing life than movement, which prevents fatigue and leads to increasing strength and vitality. Conversely, focusing solely on stillness and cultivating health only results in increasing laziness and weakness." He strongly advocated for the importance of movement in health preservation, opposing the indolent practice of "comfort," and said, "When one body moves, that body is strong; when a family moves, the family is strong..." This illustrates that the Chinese people have a long-standing tradition of valuing labor and exercise. In daily life, we can observe that people who engage in physical activity or consistently exercise are generally robust, healthy, energetic, and not obese.

When a person is at rest and inactive, their metabolism slows down, blood circulation slows down, limb muscles relax, gastrointestinal motility slows down, breathing becomes shallow, and calorie consumption drops to a minimum. Prolonged inactivity leads to muscle atrophy in the limbs, degenerative changes in tissues throughout the body, and decreased function. Therefore, we should understand that exercise is not only a means of weight loss, but also a way to promote or maintain good health.

(1) Exercise is beneficial to the function of the cardiovascular system: The heart is the power pump of blood circulation, and blood vessels, from thick to thin, are distributed throughout the body, leading to the heart. The heart pumps blood, which circulates within the blood vessels, supplying nutrients to tissues and removing metabolic waste. Increased physical activity leads to increased calorie consumption, which in turn increases the nutrient supply required by tissues and organs, and accelerates the excretion of metabolic products. Therefore, regular participation in sports can develop the cardiovascular system, thicken myocardial fibers, hypertrophy the myocardium, improve cardiac function, and strengthen the heartbeat, significantly increasing cardiac output per minute during exercise. The Beijing Institute of Sports Medicine once investigated the heart volume of 300 athletes and found that 108 athletes (36%) had a heart volume more than 10% larger than that of the average person, and 173 athletes (57.6%) had a transverse diameter of the heart more than 10% larger than that of the average person. People who exercise regularly have a slower heart rate than the average person, sometimes as low as 40 beats per minute. Because the heartbeat is slower, the heart muscle can get sufficient rest, and the heart is filled with more blood, thus greatly increasing the output per beat. In addition to enhanced cardiac function, it also improves arterial elasticity, coronary circulation, and peripheral venous activity and valve activity, thus improving the overall function of the cardiovascular system and is one of the effective methods for preventing and treating cardiovascular diseases.

(2) Exercise can enhance respiratory function: All human activities require heat, which is released from the oxidation of nutrients in the body. This oxidation process continuously consumes oxygen and expels carbon dioxide. There are two types of human breathing: abdominal breathing and thoracic breathing. Abdominal breathing is mainly accomplished by the up-and-down movement of the diaphragm, while thoracic breathing is accomplished by the intercostal muscles pulling the ribs and changing the volume of the thoracic cavity. Since human exercise consumes heat, it requires the oxidation and decomposition of nutrients. The more nutrients are decomposed, the greater the oxygen demand, and the more waste products, carbon dioxide, and lactic acid are produced. Therefore, human respiratory activity is strengthened through the regulation of the cerebral cortex, resulting in deeper and faster breathing. Thus, long-term exercise significantly enhances the activity of the diaphragm, intercostal muscles, and alveoli, and significantly increases lung capacity. Increased oxygen intake further improves cardiopulmonary function.

(3) Enhances muscle tone and bone metabolism: It is well known that people who regularly participate in physical exercise have well-developed and powerful muscles. Muscles are composed of muscle bundles, which in turn are composed of muscle fibers. All human activities rely on muscle contraction. Regular exercise makes muscle fibers thicker, stronger, and more resilient, significantly enhancing their contractility, conductivity, and responsiveness. In addition, because the muscles attached to skeletal muscles are well-developed and rich in blood vessels, blood circulation is abundant, which enhances bone metabolism and significantly increases bone elasticity and toughness.

(4) Improve the function of the digestive system: Exercise can enhance the function of the digestive system, promote appetite, and strengthen gastrointestinal motility; in addition, due to the increased up-and-down movement of the diaphragm and the increased tension of the abdominal muscles, it can promote smooth defecation. Therefore, it is especially important to remind obese people that exercise therapy must be carried out under the condition of controlling their diet, otherwise it is impossible to lose weight.

(5) It has a good effect on the mental and nervous systems: Regular physical activity can relieve mental tension, anxiety or excessive concentration, allowing the body to have a rest process. In addition, exercise is carried out under the unified and regular coordination of all the muscles in the body. The nervous system plays a leading role in the coordination of muscle activity. Exercise can enhance the conductivity and responsiveness of the nervous system, so it is also a good exercise for the nervous system.

2. Why can exercise prevent and treat obesity?

The above explains that exercise is very beneficial to all systems of the body, and it is also one of the ways to prevent and treat obesity. Why can exercise help with weight loss? Because during exercise, the body's muscles need a lot of energy, which consumes the calories ingested and promotes the burning of body fat, thus generating energy by consuming stored body fat.

As shown in Figure 1-1, the sedentary group had a high calorie intake and also gained a lot of weight; while the group engaged in heavy physical activity had a high calorie intake but did not gain much weight, demonstrating that exercise and physical activity affect weight. Exercise increases the body's basal metabolic rate, burning calories. Some believe that calorie expenditure after intense exercise can be twice that of normal calorie expenditure. A certain amount of exercise burns a certain amount of calories, and exercise also deepens and accelerates breathing, increases lung ventilation, improves gas exchange, accelerates blood circulation, and speeds up gas exchange, which is conducive to burning more fat for heat. However, simple physical activity or manual labor without simultaneous dietary control cannot achieve weight loss.