Is Pilates a Viable Alternative Form of Exercise?

There is promising evidence that Pilates can improve body composition in obese patients.

Physical activity has long been a recognized strategy and recommendation for weight loss and maintaining a healthy weight. When we think of physical activity in the context of weight loss, our minds tend to go to high-intensity aerobic exercise such as running, cycling, or swimming, or perhaps even weight training, all of which are empirically supported weight loss strategies.1: For people with obesity, this more intense exercise may not be practical to begin with, especially for those who have been sedentary and are in the early stages of incorporating increased physical activity into a weight management program.

For obese patients beginning to add exercise to their weight loss program, an alternative exercise program that offers adaptive movement patterns and no joint stress can help them build confidence and maintain motivation in the early stages. One such approach to exercise is Pilates.2: Pilates is a low-impact form of exercise that allows beginners to gradually increase cardiovascular and muscular fitness. There is growing evidence that Pilates can improve body composition, but more research is needed on its benefits for cardiometabolic health.2:

For obese patients, a Pilates program can help them lead a more active lifestyle while minimizing the risk of injury associated with exercise programs that put more stress on the joints.

Understanding Pilates and how it can add value to weight loss programs

A Pilates program engages minds and bodies as it focuses on increasing muscle control, improving posture, and improving breathing.2: Pilates works the muscles without tiring them, and many of the exercises can be performed without special equipment, although specialized equipment can be found at Pilates studios or local gyms.

Obese patients can begin mat exercises that involve lying down. However, exercises can be adapted based on any physical limitations the patient may have early on. Pilates is commonly considered a therapeutic or rehabilitative form of exercise because it focuses on improving physical fitness through movements that improve back pain, posture, movement dysfunction, musculoskeletal health, and poor functional capacity.2:

Pilates, body composition and cardiovascular health

Last revision2: reviewed studies published between 2006 and 2020 (N = 14) to examine how Pilates affects body composition, cardiometabolic health, and physical fitness. Of the 14 studies included in the review, 12 were classified as floor-based (ie, participants used a mat) and two were classified as specialized equipment-based. Training studies included Pilates interventions of four to 24 weeks duration, with Pilates sessions ranging from three to five times per week. The most commonly used Pilates protocol in 14 studies was a mat-based intervention involving three sessions per week, lasting 60 minutes per session. Thirteen of the Pilates interventions were supervised and one was semi-supervised. Across all studies, data were collected from 582 participants. Results show that Pilates improves body composition, but no evidence for cardiometabolic health.

Participants reported the greatest gains in body weight, BMI, and waist size. No effect of lean body mass was found. The review authors report that participating in 60 minutes of Pilates three times a week provides optimal benefits. Previous research3: found that multicomponent exercise, which included aerobics and strength training, had positive effects on glucose, lipid metabolism, and blood pressure. This review found no similar support for Pilates alone. The authors note that more research is needed in obese patient populations who lead a sedentary lifestyle so that the comparative effectiveness of different exercise programs can be more fully explored.

It is important to note that the authors acknowledge the limitations of their review, particularly the small number of available studies that examined Pilates as an intervention for patients with obesity. More research is needed to fully understand the effectiveness of Pilates training for obese patients. It should also be noted that the evidence from this review suggests that Pilates is a viable form of exercise due to its positive effects on body composition.

Although there is still more work to be done, healthcare professionals should still consider talking to their patients about starting Pilates exercise. Pilates is an adaptive, low-impact form of exercise that can limit the risk of injury for previously sedentary patients as they begin their transition to a more physically active lifestyle. Pilates combined with a medically supervised Low Calorie Diet (LCD) or Very Low Calorie Diet (VLCD) can help give patients the confidence to continue on their weight loss journey and lead a healthier lifestyle.


1 Regional comparisons. a global survey of fitness trends

2 Psychophysiological adaptations to Pilates training in overweight and obese people.

Comparative effectiveness of 5 types of exercise on cardiometabolic health in overweight and obese adults.

Source link