What are the Best Exercises for Obese Patients?

Training obese and overweight clients require a balanced, incremental approach. Immobility and the inherent risk for injury, heart attack, and even stroke—it all makes starting with basic movements and stabilization exercises a must. But even the most basic stabilization exercises may be too difficult for overweight patients to attempt. The result can be a frustrated patient and physical setbacks with the potential to derail physical therapy and fitness programs altogether.

With that in mind, here’s one approach to helping obese individuals sustain physical activity in a pain-free environment, helping them get the blood flowing once again.

Moonwalking with the AlterG® Anti-Gravity Treadmill™

Let’s start things off with a moonwalk. Using AlterG’s Differential Air Pressure Technology, physical therapists can use “unloaded” exercise to allow the overweight and obese patients to feel lighter during exercise. Here’s how:

  1. Have the patient step onto the AlterG® Anti-Gravity Treadmill.
  2. Initiate motion at nearly full body weight, and at a comfortable, low-grade walking speed.
  3. As the patient walks, increase body weight support in 1% increments until the patient is comfortable walking without pain. Note this body-weight level, as it should be the patient’s new target body weight.
  4. Repeat three times per week, 30 minutes per session, at the patient’s pain-free level of body weight support—and at 60% to 70% of his or her heart rate maximum.
  5. Over time, incrementally lower the body weight support. Monitor comfort level and pain closely at all sessions.

The result will be gradual progress toward target body weight and pain-free movement. Think of it as moonwalking—advanced technology that makes comfortable exercise possible (and enjoyable!) for obese individuals. When safety and comfort aren’t in question, these patients will get more out of their workouts.

Some Important Points to Remember

  • Make sure the patient is cleared by a physician. This is crucial to preventing unforeseen injuries or putting patients at risk.
  • Self-consciousness can be a major impediment. Often, overweight patients are unaccustomed to working out or to being in workout environments. They might have issues with self-image. Create a comfortable environment—isolated, if necessary.
  • Keep hydration and some simple carbohydrates on hand. Severe obesity is often linked to Type 2 Diabetes, meaning some overweight patients might suffer from this disease. Diabetes complicates exercise routines and requires scrutiny of blood sugar. Keep water and simple carbs on hand to counteract any adverse reactions.
  • Take nothing for granted. Simple things like standing up, sitting down, and getting up off the floor can pose major challenges (and lead to potential injury). Avoid prone and supine exercises. Focus on body weight exercises. Encourage patients to always engage their core, even during low-impact walking.
  • Do provide nutritional advice. Be specific and keep it simple and achievable.
  • Repeatedly assess patients throughout the progression, especially in the following areas:
    • Heart rate
    • Step counts
    • Physical and mental health
    • Anthropometric indicators
    • Rating of perceived exertion (RPE) and rating of pain
    • Diet history and daily food journals
  • Be positive and supportive. Negativity has a potential to get a toe in the door, then force its way in.

With the right approach, physical therapists can take obese and overweight patients on a journey that ends with empowering results. The stories about 150–250-pound losses are out there, and they remain an inspiration for those patients still looking at a steep climb in front of them. The tips and exercises above comprise a solid starting point—potential keys for getting over that hump and keeping obese patients on track.