Weight loss can be a challenging process physically and psychologically. Unfortunately, many people are told to lose weight by a health professional in quite a dismissive way. Most people who would benefit from losing weight are aware and have already tried to do something about it! 

While a physiotherapist isn’t the obvious person to seek advice from on weight loss, it is often an important factor in pain, injury, or managing a specific health condition. For example; weight gain is common in people with long term pain or injury, as they are unable to maintain their previous activity levels; carrying excess body fat can increase pain and contribute to a number of health conditions; and some people’s injuries occur when commencing weight loss exercise.

Probably more important than excess weight on joints is the constant inflammatory load that comes with higher levels of adipose tissue (fat). Adipose tissue increases inflammation in your body, which can increase inflammatory pain in joints, nerves, tendons, and other structures. Thankfully, exercise is a very good way to regulate inflammation, even in the absence of weight loss!

What type of exercise is best for weight loss?

The short answer - whichever activity you enjoy and are able to do regularly and long term. Weight loss is a slow process. It’s important to create an enjoyable and sustainable habit that you can see yourself doing in 6 months, 2 years, 10 years. Two little tips:

• Finding something social can be a great way to boost the enjoyment of an activity

• Building regular movement into your daily routine helps

You’re probably aware that the intention of exercise in weight loss is to use up energy that is consumed as food, and energy that is stored as fat. 

Aerobic exercise aka “cardio” is a good way to use a lot of energy and can be done on most days. Examples of aerobic exercise are walking, swimming, cycling, gardening. The government recommendations for aerobic exercise are for 2.5-5 hours of moderate intensity and 1.25-2.5 hours of vigorous intensity exercise per week. An easy way to judge your exercise intensity is: during moderate intensity exercise you can talk comfortably, but for vigorous exercise you can’t say more than a couple of words at a time. 

If you’re new to aerobic exercise, start with 15-30 minutes of moderate intensity exercise, aiming for 2-3 sessions per week, giving your body at least one day to recover in between each session. If you already do regular aerobic exercise, you may be able to introduce some bouts of vigorous intensity. An example would be to include 30 seconds of jogging every 5 minutes within your 30 minute walk. After a few weeks of this you can increase the amount of jogging gradually, keeping within that ‘few words at a time’ intensity. 

Resistance exercise is best for increasing your muscle mass, and people with more lean muscle mass tend to have a higher resting metabolic rate, meaning more energy is being used at rest. For the purpose of building muscle for health and weight loss, you want to focus on compound movements and large muscle groups. Some good examples of this are push ups, rowing, squats, and step ups. These movements could all be done with an aerobic focus, but to bias strength improvements you want a challenging resistance so you can only do a small number before needing a rest. An example of these exercises at an entry level would be a wall push up, row with a resistance band, half squat, and step ups holding a rail. From there each exercise can be made gradually more challenging as strength is gained. 

If you’re new to resistance exercise it’s good to start with 2 sets of 10-15 repetitions per exercise. As you become more familiar with an exercise and build strength, you can add more sets, or increase the resistance. Government recommendations suggest a minimum of 2 sessions of strength exercise per week. 

How to avoid an injury setback

If you are changing or increasing your level of activity for weight loss, you certainly don’t want your efforts halted by an injury! 

The best way to avoid an injury is to be gradual with adding and increasing exercise. Your body is fantastic at adapting to what you do regularly, but this takes time. 

It’s important to plan your exercise progression from what you currently do to what you want to be doing. The aim of week 1 isn’t to reach the end goal, it’s just to get started, build the routine, and let your body adjust to new activities or intensities.. Map out a small increase every 3-4 weeks, and with each increase allow extra rest days for your body to recover so you can evaluate how you’ve responded. 

For example, you may start with 3 walks of 30 minutes, and 2 strength sessions. After 4 weeks you may feel ready to increase your walking; an option is increasing one walk to 40 minutes, evaluating afterwards and the following day how you’ve recovered. Keep the others at 30 minutes this week, changing the second to 40 next week, and the third to 40 the following week, making the overall walking increase more gradual. 

If you also want to increase your resistance exercise, you could hold weights during your squats, starting with 5-8 kg and paying attention to how your legs feel the following day. While it’s normal to feel post exercise soreness, it shouldn’t last any more than 1 day, or following a big increase up to 3 days.

When constructing a progressive exercise program, we usually schedule a deload week every 4-5 weeks. This is a week where you do much less, allowing your body to catch up with the consistent increases. It also helps to fight against dropping motivation and boredom. You could schedule this week for a holiday or week that you know your time is limited. Either way, it’s important to pause every now and then to let your body catch up and reduce your risk of injury. 

Whether you’re trying to lose weight to reduce pain or improve your health, exercise can be very helpful in this process. By using these ideas you will be able to maximise the benefits of exercise for your health and when paired with appropriate nutrition and medical support achieve a healthy body weight. If you need more personalised guidance, consult a physiotherapist or exercise physiologist.