David Baron, DO - Member, RiverMend Health Scientific Advisory Board for Eating Disorders & Obesity Dr. Baron addresses the RiverMend Health Scientific Advisory Board on how diet and exercise are key in obesity treatment. To watch lecture visit :http://vimeo.com/112420862 For more information visit: http://www.rivermendhealth.com/scientific-advisory-board-addiction.html

1. Exercise as a Treatment for Weight Loss
and Well-Being
David Baron, DO

2.  Physiologic effects of exercise well documented
– Runner high(opioid)
– Increased self-esteem
– Caloric control improved
– Effective treatment for Depression

3.  Substantial evidence, retrospective, prospective, animal &
human,
 Exercise has a neuroprotective effect (Kramer,Erickson,Colcombe)
 Delay the onset of cognitive decline,Alzheimer’s
 Proliferation of active capillary beds
 New dendritic connections
 Neuronal growth in hippocampus
 Data demonstrated exercise several/week(Institute Brain
Aging UCI)
– Reduces rate of cognitive decline with age
– Increases BDNF
– Decreases B-amyloid

4.  Gunstad J.in press Comprehensive Psychiatry
– 408 subjects
– 20-82 yo
– Body mass index inversely related to performance all
cognitive tests
 Regular exercise improved cognitive performance
 Overall sense of well-being

5.  Diet and exercise represent the mainstays of obesity
treatment. No systematic review has been
conducted comparing the effect of dietary and
exercise intervention in reducing metabolic risks in
overweight children.
 To compare the effects of diet-only intervention
with those of diet plus exercise or exercise only on
weight loss and metabolic risk reduction in
overweight children.

6. Date of download: 3/4/2014
Copyright © 2014 American Medical
Association. All rights reserved.
From: Impact of Dietary and Exercise Interventions on Weight Change and Metabolic Outcomes in
Obese Children and Adolescents: A Systematic Review and Meta-analysis of Randomized Trials
JAMA Pediatr. 2013;167(8):759-768. doi:10.1001/jamapediatrics.2013.1453
Flowchart for Identification of Trials for Inclusion in the Systematic Review and Meta-analyses

7.  Obesity in children and adolescents is a major public
health problem, with high or increasing prevalence
reported in many countries
 Diet and exercise represent the mainstays of obesity
treatment
 unclear whether diet plus exercise or exercise only is
more effective than a diet-only intervention for
improving weight status in overweight and obese
children and adolescents

8.  Fifteen studies were identified 1975-2010
 Both diet-only and diet plus exercise interventions
resulted in weight loss and metabolic profile
improvement.
 Addition of exercise to dietary intervention led to
greater improvements in
– HDL
– Fasting glucose, fasting insulin
– triglycerides
– Improved sense of well-being

9.  Dietary interventions in conjunction with exercise
interventions are effective in reducing metabolic
risks, particularly HDL-C and fasting insulin levels,
in overweight and obese children

10.  How much is enough(exercise and weight loss)
 Must be enjoyable
– Reward
– Negative reinforcement
– Punishment
 Aerobic vs anaerobic
 Effect throughout life-cycle (peds-gero)
– Gonadal steroid modulation
 Fad diets vs sound nutritional intake
– Many claims, limited data
 Supplements, herbs etc
 All things in moderation
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