Physical Activity Interventions

Benefits of Physical Activity

Abundant evidence has demonstrated that adequate levels of physical activity are important for weight management. These benefits include weight loss, particularly when combined with reduced calorie intake, and the prevention of weight regain following initial weight loss (US DHHS, 2018). The benefits are greatest with higher levels of moderate to vigorous physical activity, and people who are trying to lose weight may need higher levels of physical activity than those who are trying to maintain their weight (US DHHS, 2018). Primary care providers can provide recommendations to older adults regarding appropriate amounts of physical activity and strategies to increase their physical activity (Pennings et al., 2025).

The U.S. Department of Health and Human Services (US DHHS) Physical Activity Guidelines for Americans offer recommendations across the lifespan.

Key guidelines for adults from this report include (US DHHS, 2018):

 Move more and sit less throughout the day.

Some physical activity is better than none. Adults who sit less and do any amount of moderate to vigorous physical activity gain some health benefits.

For substantial health benefits, adults should do at least 150 to 300 minutes a week of moderate-intensity, or 75 to 150 minutes a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity.

Preferably, aerobic activity should be spread throughout the week.

Additional health benefits are gained by engaging in physical activity beyond these amounts.
Adults should also do muscle-strengthening activities of moderate or greater intensity that involve all major muscle groups on 2 or more days a week, as these activities provide additional health benefits, including maintaining muscle mass and physical function.

Practice Pearl | Physical Activity Guidelines

Dennis Villareal, MD, Professor of Medicine, Division of Endocrinology, Diabetes & Metabolism, Baylor College of Medicine, Staff Physician, Michael E. DeBakey VA Medical Center

Physical activity guidelines indicate that older adults should have at least 150 minutes a week of moderate-intensity activity and 75 minutes of vigorous aerobic activities, along with two days a week of strength and balance exercises. Any kind of physical activity is better than none at all, and even a single session can lead to immediate benefits. Start slow, play it safe with low intensity, warm up and cool down, and tailor activities to the individual’s preferences and health conditions.

Additional recommendations from the Physical Activity Guidelines for older adults
include (US DHHS, 2018):

As part of their weekly physical activity, older adults should do multicomponent physical activity that includes balance training as well as aerobic and muscle-strengthening activities.

Older adults should determine their level of effort for physical activity relative to their level of fitness.

Older adults with chronic conditions should understand whether and how their conditions affect their ability to do regular physical activity safely.

When older adults can't do 150 minutes of moderate-intensity aerobic activity a week due to chronic conditions, they should be as physically active as their abilities and conditions allow.

All adults, and particularly older adults and those who have been sedentary, should take care when increasing their levels of physical activity to avoid injuries or other negative effects.

The Physical Activity Guidelines call for people to (US DHHS, 2018):

Understand the risks, yet be confident that physical activity can be safe for almost everyone.
Choose types of physical activity that are appropriate for their current fitness level and health goals, because some activities are safer than others.  
Increase physical activity gradually over time to meet key guidelines or health goals.

Inactive people should “start low and go slow” by starting with lower intensity activities and gradually increasing how often and how long activities are done.

Protect themselves by using appropriate gear and sports equipment, choosing safe environments, following rules and policies, and making sensible choices about when, where, and how to be active.
Be under the care of a health care provider if they have chronic conditions or symptoms.

People with chronic conditions and symptoms can consult a health care professional or physical activity specialist about the types and amounts of activity appropriate for them.

When working with older adults to develop plans and goals for physical activity, discuss daily routines and when they can schedule physical activity, as well as the options and opportunities that are available to them for safe physical activity. Consider whether it is appropriate to involve physical therapy to help with starting the process and addressing conditions that limit the ability to engage in some types of physical activity.

Resources

The Centers for Disease Control and Prevention provides a resource on Adding Physical Activity as an Older Adult. 
The Office of Disease Prevention and Health Promotion’s Move Your Way campaign provides materials that are tailored to older adults. 
The National Institute on Aging offers resources on Exercise and Physical Activity.
The US DHHS Physical Activity Guidelines for Americans Midcourse Report provides Implementation Strategies for Older Adults.
Additional information and resources about physical activity for older adults is available from the American College of Sports Medicine and the International Exercise Recommendations in Older Adults (ICFSR): Expert Consensus Guidelines.
The Academy of Nutrition and Dietetics’ article on Medical Nutrition Therapy Interventions Provided by Dietitians for Adult Overweight and Obesity Management: An Academy of Nutrition and Dietetics Evidence-Based Practice Guideline (2023)

Other Guidelines

Additionally, the American Diabetes Association (ADA) annually publishes Standards of Care in Diabetes, including standards for obesity and weight management for the prevention and treatment of type 2 diabetes. The Obesity Association, which is a division of the ADA, is developing Standards of Care in Overweight and Obesity (Annual).

Several other authoritative organizations have also published guidelines for treating obesity. However, many of these are older and do not incorporate more recently developed treatment approaches. The most prominent of these guidelines include:

American Association of Clinical Endocrinologists (AACE)/American College of Endocrinology (ACE): Comprehensive Clinical Practice Guidelines for Medical Care of Patients with Obesity (2016)
American Heart Association (AHA)/American College of Cardiology (ACC)/The Obesity Society (TOS): Guidelines for the Managing of Overweight and Obesity in Adults (2013)
US Preventive Services Task Force (USPSTF) : Weight Loss to Prevent Obesity-Related Morbidity and Mortality in Adults: Behavioral Interventions (2018)

Evaluate | Approaches to Implement