How Do You Get Rid of Belly Fat?

There are numerous strategies to eliminate belly fat. The most crucial result comes from improving overall health, as belly fat raises the risk of diabetes, heart disease, metabolic syndrome, and cancer. This fat is deemed as visceral fat, which is a hidden type of fat that clings around internal organs. Even slim folks can have this fat.

Just because someone looks thin does not mean they are fit. Maintaining a normal weight index does not guarantee there is no abdominal fat and the deadly health concerns connected with it. It is simply a common myth. It is vital to get rid of the deep belly fat, which is highly reactive and dangerous. Recent studies show that fat cells are unique and that there are different kinds of fat cells that have their own genes.

There is no magic pill for flattening the tummy, but there exist several simple strategies to expel it. Focusing on diet, exercise, and lifestyle is the best approach to losing belly fat. Abdominal crunches, sit-ups, and excessive exercise machines are not needed to attain a trim, flat waistline.

These methods are outdated and do not address the internal, invisible problem of visceral fat. The 5-component strategies outlined below boost the metabolism, block absorption, curb appetite, burn off fat, and reduce stress. These may seem like difficult alterations to execute but can become easy habits with practice over time.

The first step is to join the healthy eating paradigm. It is important to lessen or eradicate fattening foods such as sugar malts, pies, fast food, and fried foods from the diet. Weight loss results from expelling junk foods. Whole, natural foods such as fruits, vegetables, beans, fish, rice, and legumes should form the basis of the diet.

These foods contain natural vitamins, minerals, and fiber that help boost the metabolism and block appetite. The body cannot handle frankenfood and artificial substances, which are devoid of nutrients and only clog the body with fat. Fat cells have their own blood supply and help regulate appetite, blood pressure, and other hormones.

1. Introduction

Belly fat, also known as visceral fat, is the fat that accumulates around the abdomen and is associated with an increased risk of various health issues such as heart disease, type 2 diabetes, and certain cancers. Losing belly fat requires a combination of dietary changes, increased physical activity, and lifestyle modifications.

This essay examines four effective strategies for losing belly fat: incorporating healthier foods, increasing physical activity, engaging in strength training, and reducing stress levels.

Incorporating healthier foods such as fruits, vegetables, lean proteins, and whole grains into the diet can help to create a caloric deficit, which is necessary for weight loss. Sugary drinks, processed foods, and high-fat meats should be avoided or limited, as they can contribute to increased belly fat.

Increasing physical activity, such as aerobic exercises, can help to burn calories and reduce overall body fat, including belly fat. Strength training exercises can also help to build muscle mass and increase metabolism, making it easier to lose fat.

Strength training exercises, such as weightlifting, bodyweight exercises, or resistance band workouts, can help to build muscle mass and increase metabolism. This can help to burn more calories, even when at rest, and make it easier to lose belly fat. Reducing stress levels is essential for preventing the accumulation of belly fat.

Increased cortisol levels due to stress can lead to increased appetite, cravings for unhealthy foods, and fat storage around the abdomen. Engaging in activities such as yoga, meditation, or spending time in nature can help to reduce stress levels and promote overall well-being.

2. Understanding Belly Fat

Belly fat, medically referred to as visceral fat, is a type of fat that accumulates in the abdominal cavity and forms around organs such as the liver and intestines. This term generally refers to a group of diseases and conditions, one of which is a waist circumference of more than 40 inches (102 cm) for men, and 35 inches (88 cm) for women.

It can also refer to an apple-shaped body type, which has been shown to cause serious diseases of the heart, diabetes, strokes, and certain types of cancer. Understanding the types of belly fat, along with the associated health risks, can help individuals target their fat burning efforts for greater success.

There are two types of belly fat: subcutaneous and visceral. Subcutaneous fat is generally not harmful. It is the fat located just below the skin in the abdomen, hips, thighs, and arms. This fat can be pinched, and it is the type that people primarily want to get rid of reducing subcutaneous fat often leads to a more toned and slimmer appearance.

Visceral fat is harmful, as it is located deep within the abdomen, surrounding the liver, pancreas, kidneys, intestines, and other organs. This type of fat is not detectable by physical examination and cannot be pinched. Studies have shown that this type of fat is the greatest risk factor for diseases associated with obesity because of the chemicals it releases, which cause a wide range of system malfunctions.

There are a multitude of health risks associated with belly fat, but the three that cause the greatest concern are type 2 diabetes, heart disease, and cancer. There are many complicated processes that take place in the body as a result of belly fat, but the following summarises the most basic and well-known methods by which these three diseases may be precipitated:

Belly fat cellular chemicals cause insulin to stop placing glucose into cells; stress hormones, such as cortisol and epinephrine, that cause fats and sugars to be released into the blood may be released in excess; blood lipids, such as cholesterol and triglycerides, may increase in the blood, which stimulate atherosclerosis in arteries; and growth factors may be increased, which affect cell growth comorbidities, such as protein kinases and cyclins, which may eventually lead to cancer.

An individual can discover their level of belly fat by measuring waist circumference and body shape, or more accurately by determining body mass index and waist-to-hip ratio. However, these methods do not precisely indicate the degree of visceral fat, which is the most harmful type of belly fat. A CT scan or MRI can tell the exact amount of visceral fat, but these methods are expensive. A new method developed by Japanese researchers in 2001 involves using ultrasound to estimate visceral fat area.

A trained technician places a probe on the skin above the navel and uses a computer to analyse the fat tissue depth, which can be indicated with a numeric value. An individual can clarify their level of belly fat with greater accuracy by having a waist circumference measurement, a body mass index body fat level percentage measurement, and an assessment of visceral fat area using ultrasound.

2.1. Types of Belly Fat

In general, fat is classified into two types: visceral and subcutaneous. Visceral fat is the deep, organ-abdominal cavity fat that is located between the internal organs. This type of fat can be harmful, as it is prone to be released into the bloodstream, leading to metabolic diseases. Although visceral fat can be difficult to detect, it’s possible to determine your level of visceral fat using a CT/MRI scan or even a bioelectrical impedance scale. It can also be detected indirectly using waist circumference measurements.

In general, men with waist measurements of 40 inches (102 cm) and above, and women with waist measurements of 35 inches (88 cm) and above are classified as high-risk for visceral fat. The good thing is that visceral fat is more sensitive to diet and exercise changes than subcutaneous fat. It can be lost more quickly within a month of adopting healthy lifestyle habits.

Subcutaneous fat is the fat that lies just beneath the skin. It can be grabbed with your hands and measured with calipers. Subcutaneous fat is considered harmless, even though individuals may have more subcutaneous fat than average. Subcutaneous fat is increased during alcohol, smoking, obesity, and caloric surplus consumption; however, these factors are more correlated with visceral fat gain than with subcutaneous fat gain, which means they don’t necessarily raise your risk of metabolic diseases.

Waist circumference measurements can be used to detect the presence of subcutaneous fat, but they can’t be used to determine a person’s level of subcutaneous fat. It can be estimated by doing waist-to-hip measurements, waist-to-height ratios, and determining the waist circumference relative to body mass index (BMI), but these estimations can vary greatly.

2.2. Health Risks Associated with Belly Fat

The accumulation of belly fat is a widespread concern that is, unfortunately, associated with a range of health risks. While excess fat may be found on other regions of the body, this section focusses on the reasons why it is vital to know how to effectively lose belly fat. Adiposity can lead to a series of disorders, such as elevated blood cholesterol, hypertension, glycemia, and triglycerides.

In fact, abdominal obesity is most frequently linked to the metabolic syndrome, which consists of the above disorders combined with unhealthy inactivity, eating, and lifestyle habits. All of those are precursors to heart disease, kidney failure, stroke, and type 2 diabetes. The metabolic syndrome is oftentimes misdiagnosed because other types of obesity are assessed when looking for it (e.g., total fat mass, body mass index, waist circumference). Moreover, not all kinds of fat, or belly fat, are risky.

Like other adipose tissues, belly fat functions as an energy reservoir, insulated body heat, and endocrine organ. However, unlike other fat pads, the accumulation of visceral fat leads to a disruption of the nervous, vascular, and multi-hormonal regulation of adipose tissues. As a result, excessive visceral fat mass boosts the liberation of free fatty acids and pro-inflammatory cytokines into the bloodstream, causing an inflammatory process in tissues that eventually leads to the aforementioned disorders.

The accumulation of visceral fat has been linked to the overproduction of several risk factors, such as leptin, plasminogen activator inhibitor 1 (PAI-1), fibrinogen, and angiotensinogen; and it is related to the underproduction of adiponectin. Collectively, this adiposity-induced combination of problems is called “adipose tissue dysfunction.” It is well established that at least two different fat depots exist on the abdomen—superficial abdominal fat and deep abdominal fat.

The former subsists throughout life, only increasing during times of energy imbalance, and is not influenced by hormonal changes, ageing, reproductive state, or environmental factors. Conversely, the amount of the latter increases first postpartum, and slowly with ageing, resulting in a “visceral shift” at older ages amidst a significant fall in overall fat mass.

3. Factors Contributing to Belly Fat

The accumulation of belly fat is a complex issue influenced by various dietary and lifestyle factors. Understanding these underlying causes can help individuals develop effective strategies for losing this stubborn fat.

Diet is a significant contributor to the accumulation of belly fat. The Western diet, characterised by a high intake of refined carbohydrates and unhealthy fats, has been linked to central obesity. A diet rich in sugar-sweetened beverages, trans fats, and processed foods can promote the deposition of visceral fat.

Conversely, a healthy diet abundant in fibre, fruits, vegetables, whole grains, and lean protein sources can aid in reducing belly fat. Additionally, certain foods have been shown to specifically target belly fat, such as avocados, nuts, legumes, olive oil, and fatty fish. It is crucial to consider portion size and overall caloric intake, as excessive consumption of healthy foods can still lead to weight gain.

Besides diet, lifestyle factors also contribute significantly to belly fat accumulation. These include sedentary behaviour, poor sleep quality, and high levels of stress. Sedentary behaviour, characterised by prolonged sitting, is common in modern society due to the increased use of cars and computers, leading to abdominal obesity.

Poor quality sleep, such as short duration or high fragmentation, can alter appetite-regulating hormones and increase cravings for sugary foods, resulting in weight gain. Chronic exposure to stress activates the hypothalamus-pituitary-adrenal (HPA) axis, leading to the production of cortisol, which can direct fat storage to the abdomen.

3.1. Dietary Factors

A balanced diet can make a massive difference to overall wellbeing and weight control. It can be tempting to crash diet, but this can lead to a yo-yo effect with weight fluctuating up and down, which could be risky. Making changes to everyday eating habits and food choices is a more sensible long-term approach 1. If you want to lose belly fat:

*Cut back on sugar and processed foods. Pay close attention to what is being eaten and do not eat anything unless it has been planned beforehand. Random snacks and treats should be avoided as much as possible, and processed foods should be cut out entirely, as they are laden with sugar.

*Increase fibre intake. Aim to eat a 30g fibre diet a day, eating more fruits, vegetables, whole grains, nuts, and seeds. This will encourage healthy gut bacteria and help with cravings and weight loss.

*Incorporate more protein. One should aim to eat a source of protein with every meal to build muscle and burn more calories. This could be meat, eggs, dairy products, or plant-based sources like nuts, beans, and lentils.

*Eat healthy fats. Fats are not the enemy; healthy fats from avocados, olive oil, nuts, seeds, and oily fish keep you fuller for longer, which helps avoid the temptation to snack.

*Practice portion control. Even healthy food can lead to weight gain if not eaten in moderation. One should pay attention to serving sizes and be mindful of what is on the plate and the need for a second helping.

*Practice mindful eating. Work on being more aware of how, when, where, and why you eat food, paying attention to it as a sensory experience. This can effectively tackle cravings and overeating, especially at stressful times.

3.2. Lifestyle Factors

There are several lifestyle factors that can lead to increased belly fat, including lack of sleep, chronic stress, certain medications, and alcohol consumption. Sleep is essential for good health, and a lack of sleep can lead to hormonal imbalances that increase appetite and cravings for unhealthy foods. Research has shown that people who do not get enough sleep are more likely to be overweight or obese, and that improving sleep can lead to weight loss.

Chronic stress can also lead to the accumulation of belly fat. When a person is under stress, the body produces high amounts of the hormone cortisol, which is known to increase appetite, particularly for unhealthy foods. Research has shown that people who are more stressed tend to store more fat in the belly region.

Certain medications can cause weight gain as a side effect, and many of these medications lead to an increase in belly fat. Some common medications that can cause weight gain include certain antidepressants, anti-seizure medications, diabetes medications, and glucocorticoids.

Drinking too much alcohol can also lead to weight gain, particularly in the abdominal area. Studies have shown that people who consume a lot of alcohol are more likely to have a larger waist circumference, and excessive alcohol consumption has been linked to an increased risk of developing belly fat.

There are several lifestyle factors that can lead to increased belly fat, including lack of sleep, stress, certain medications, and excessive alcohol consumption.

4. Effective Diet and Nutrition Strategies

Numerous routes exist to get rid of a bloated belly or get rid of blubber. The best advice is typical of what your grandmother would have given you. In fact, there is a known saying, “An apple a day keeps the doctor away.” Thus, eating sensibly is the best strategy to getting and staying thin. However, some people argue about the meaning of the word sensible, as in sensibly. It means moderation, not scanty or meagre. A good basic rule to remember is that you should not eat a lot of any one type of food.

Furthermore, to hasten your loss, you will have to get rid of alcohol, or drink in moderation only. Alcohol contains unexpected calories, particularly empty calories. A glass of wine will add one hundred calories to your daily total. Three glasses will add three hundred calories. This approach works on the theory of diminishing returns. With lesser degrees of aggression, a person can manage the loss without going to the tottering extremes. Again, the best advice is to submit to discipline and learn control over petty luxuries.

Great advantages come from losing as little as ten pounds, particularly in terms of improvements for diseases involving obesity, including diabetes and coronary conditions. As always, you should determine if any diet or exercise plan is right for you. A fast way to lose a lot of weight is to undereat and starve themselves. If you lose weight this way, you will more than likely gain the weight back.

4.1. Balanced Macronutrient Intake

Belly fat loss requires incorporating a variety of healthy, nutrient-dense foods, but not all types of foods are equal in supporting weight-loss goals. Ensuring macronutrients are balanced in the diet is one of the key components of a successful fat-loss plan. Carbohydrates, proteins, and healthy fats are the three macronutrients that make up the majority of the food we consume.

Each plays an important role in the body, and testing a variety of these food types will help one discover a combination that works best for regulating hunger and metabolism.

Building meals and snacks around satisfying macronutrients is an effective appetite-control strategy that results in improving body composition. The following is a simple guide to achieving a macronutrient balance that supports belly fat loss. Carbohydrates often get blamed for weight gain, making them feel like an “enemy” in the battle against fat.

The truth is: it is too much of the wrong type of carbohydrate that leads to weight gain. Focussing on eating whole-food, high-fiber sources of carbohydrates such as fresh vegetables, fruit, beans, and whole grains provide the nutrients necessary for belly fat loss 1.

4.2. Fiber-Rich Foods

Including more fiber in your diet is a good way to lose belly fat. There are two types of fiber: soluble and insoluble. Soluble fiber dissolves in water and mostly found in foods like oatmeal, nuts, apples, and beans. Insoluble fiber does not dissolve but helps move food through the digestive tract. Both types aid in weight loss 1.

High-fiber foods take longer to digest, which makes you feel full longer. They also help control hunger and appetite, so you’re less likely to snack on unhealthy foods. Fiber also regulates insulin levels, lowers bad cholesterol, and maintains gut health. Foods that are a good source of fiber include lentils, chia seeds, oats, pears, barley, avocado, apples, Brussels sprouts, and beans.

4.3. Healthy Fats

In the past, fat consumption was verified, and many people resorted to consuming low-fat diets laden with hidden sugars and highly processed ingredients. Nowadays, fats are treated with more respect, and recent research highlights the benefits of including healthy fats in one’s diet. The goal is to lower unhealthy visceral fat.

Though abdominal fat may seem harmless compared to fat in other areas of the body, it is harmful and considered “metabolically active.” It releases proteins and hormones that lead to heart diseases, metabolic syndrome, diabetes, and systemic inflammation.

In particular, trans fats pose a great risk of gaining unhealthy belly fat. They are difficult to distinguish since the food industry cleverly disguises them. Trans fats are technically unsaturated fats processed to become solid. During that process, some unsaturated fats become trans isomers instead of cis, with opposite molecular alignments.

As a result, trans fats become rigid and dangerous like saturates while retaining the features of unsaturated fats. Trans fats are responsible for raising bad cholesterol and even lowering good cholesterol. Bad publicity prompted the food industry to replace hydrogenated oils with palm oil, which is more natural but still raises LDL cholesterol.

Healthy fats are either saturated or unsaturated fats that are nourishing and good for health. Palm oil, though classified as saturated, is suitable for cooking as it has a high smoking point and contains nutrients like vitamin E, phenolic compounds, and carotenoids. “Good” cholesterol levels can be raised by substituting saturated fats with palm oil.

Unsaturated fats are the gold standard, typically referred to as healthy fats. They are classified into monounsaturated fatty acids found in avocado, nuts, fish, and certain oils, and polyunsaturated fatty acids containing omega-3 and omega-6. The ideal ratio of 1:1 to lower abdominal fat and CVD risk is challenging to maintain. Palm oil can help achieve a healthy balance by providing saturated fats that lower the risk of tummy fat and typifying unsaturated fats that increase CVD and belly fat risk.

5. Physical Activity and Exercise

Physical activity and exercise are crucial components of any effective strategy for losing belly fat. Regular physical activity can help to burn calories and fat, and maintain a healthy weight. Cardiovascular exercise, such as running, swimming, or cycling, can help to burn a large number of calories and fat, particularly during high-intensity workouts. Strength training, such as weightlifting or bodyweight exercises, can help to build lean muscle mass, which can help to increase metabolism and burn more calories even at rest.

Incorporating physical activity into daily routines, such as walking or cycling to work or taking the stairs instead of the elevator, can also help to increase overall activity levels and improve health. According to guidelines from the Centres for Disease Control and Prevention, adults should aim for at least 150 minutes of moderate-intensity aerobic exercise, such as brisk walking, each week, in addition to strength training activities on two or more days per week 2.

In addition to a healthy diet and weight loss, physical activity is an important component of any effective strategy for losing belly fat. Exercise can help to reduce stress by promoting the release of endorphins, which can improve mood and reduce feelings of anxiety and tension. Physical activity can also help to improve sleep, which is important for overall health and weight management.

Finding a form of physical activity that is enjoyable, such as dancing, playing a sport, or hiking with friends, can increase the likelihood of sticking to a regimen in the long term. Joining a class or group, or finding a workout partner, can also provide social support and motivation to stay active.

5.1. Aerobic Exercise

Aerobic exercise, also known as cardio, is one of the most highly effective forms of exercise for losing belly fat. The American Heart Association recommends at least 150 minutes of moderate-intensity aerobic exercise per week for adults. Moderate-intensity activity increases your heart rate and makes you breathe harder, but also allows you to converse comfortably.

Popular low-impact,, moderate-intensity aerobic exercise options to consider include walking or biking. High-impact activities such as jogging, high-intensity aerobics, or playing football are also popular options. The more vigorous the activity, the more calories you burn, helping you to lose belly fat.

For substantial benefits, the American Heart Association recommends at least 75 minutes of vigorous-intensity exercise per week. It’s important to accumulate activity in bouts of at least 10 minutes. Additional health benefits, including lower risk for chronic diseases and certain cancers, are seen when moderate-intensity exercise exceeds 300 minutes.

Conversing while exercising can help gauge intensity. If you can say only a few words without pausing for breath, it is likely too vigorous. Honouring this guideline can help you develop an aerobic exercise-based programme to lose belly fat: Aim for 150 minutes at moderate intensity (or 75 minutes at vigorous intensity) for the first week, then increase to 300 minutes at moderate intensity (or 150 minutes at vigorous intensity) by the following week.

Brisk walking (4 mph or faster) counts as moderate; running (5 mph or faster) counts as vigorous. Other options for low-impact, moderate-intensity aerobic exercises to lose belly fat include swimming, hiking, dancing, or playing basketball. High-impact activities to consider for vigorous-intensity aerobic exercises include jogging, aerobics, soccer, basketball, and jumping rope.

Pilates or yoga are examples of low-impact activities that are not high enough in intensity to count for aerobic exercise. In general, moderate-intensity exercises work the large muscles in the arms, legs, back, and torso. A good way to gauge whether your aerobic exercise is intense enough is called the “talk test.”

You should be breathing harder while exercising than when at rest, but you should still be able to comfortably carry on a conversation. Efforts that you can only say a few words without pausing for breath are likely too vigorous. Consider alternating between moderate- and vigorous-intensity activities.

“Fartlek” running is an example of a way to alternate intensity during a single workout wherein a runner sprinkles in short bursts of speed to a base pace. Whether gradually increasing your exercise intensity or duration and frequency, or varying intensity during a single workout, do this cautiously – in increments of no more than 10 percent per week – to avoid injuries.

5.2. Strength Training

Strength training, also referred to in various contexts as resistance training or weight training, enhances muscles through exercises employing resistance, such as weights, bands, or one’s body weight. Individuals can experience significant health improvements, including reducing belly fat, cardiovascular disease risk, and declining muscle mass, even with as little as 30 minutes a week of strength training.

Strength training can be completed using gym machines, free weights like dumbbells and medicine balls, elastic bands, or body weight. It can be practiced at a gym, home, park, or even outside.

Belly fat, also known as abdominal fat, accumulates around the belly or abdomen and is associated with increased health risks, including cardiovascular disease and type 2 diabetes. Aerobic exercise is well-known for reducing obesity and belly fat. However, there is a lack of strong evidence on the effectiveness of strength training on abdominal fat. Strength training could potentially lessen overall and abdominal fat, but findings have been inconsistent.

Nevertheless, many studies have reported a reduced risk of belly fat, and even without a significant change in abdominal fat, strength training could still improve belly health. Further studies are needed to explore the mechanisms underlying belly fat accumulation and loss, particularly with regard to resistance training.

Recent studies highlight the positive effect of resistance training on abdominal fat and visceral fat mass, and these findings still hold after controlling for aerobic exercise. Resistance training could significantly reduce body fat and abdominal fat, even without dietary modification, and in some studies, the exercise effect on abdominal fat was greater for resistance training than aerobic exercise.

In response to exploring the relative effectiveness of strength training and aerobic exercise, a subsequent study showed that only aerobic exercise significantly reduced waist circumference. Waist circumference is an indicator of abdominal fat, and there is a weak association between resistance training and waist circumference.

Results on the effectiveness of resistance exercise to reduce abdominal fat mass are less consistent when using MRI and CT imaging methods. Results suggest that strength training sessions at the recommended minimum of 2 times a week with 2–3 sets of 8–12 repetitions are needed for any substantial abdominal fat loss.

Also Read: Effective Exercises to Lose Belly Fat

 

6. Lifestyle Changes: How Do You Get Rid of Belly Fat?

Incorporating specific lifestyle changes into your daily routine can significantly promote belly fat reduction and overall health improvement. Prioritise seven to nine hours of quality sleep every night to maintain optimal health and boost fat loss. A well-rested body can effectively manage blood sugar levels, appetite, stress hormones, and energy levels. Therefore, find a sleep schedule that works for you and stick to it, ensuring a calm environment conducive to sleep, including avoiding screens and dimming the lights an hour before bedtime.

Stand up, stretch, or walk around the room at least once an hour to switch up your body position, which is key to fighting belly fat. Research shows that standing burns 50% more calories than sitting, making it important to regularly walk about during meetings, phone calls, or while on breaks. Furthermore, sitting too long also increases the risk of diabetes, heart disease, and premature death, all while causing further weight gain and fat redistribution to the belly area.

Another effective strategy to reduce belly fat is reducing alcohol intake. Nevertheless, it is impossible to be told to stop drinking altogether, especially if one regularly has social commitments or enjoys a daily glass of wine. However, studies indicate that even small reductions in alcohol intake can aid weight loss.

One promising approach is to use a smaller glass or drink lower-alcohol drinks, as people generally drink less when provided with smaller containers, while switching from pints to smaller servings can likewise decrease caloric intake. Quit smoking, even though it may seem impossible.

Research shows that the only two effective ways to assist in quitting smoking are enlisting the help of a doctor and seeking advice from the Quit organisation. Consider trying electronic cigarettes, allowing nicotine intake without the harmful tar and other chemicals in cigarettes. Compared to traditional cigarettes, electronic cigarettes can help quit smoking, but it is also important to work towards giving up electronic cigarettes to combat belly fat since they are also associated with weight gain.

References:

1. Young Kim J. Optimal Diet Strategies for Weight Loss and Weight Loss Maintenance. 2021. ncbi.nlm.nih.gov

2. Dalle Grave R, Calugi S, Centis E, El Ghoch M, et al. Cognitive-Behavioural Strategies to Increase the Adherence to Exercise in the Management of Obesity. 2011. ncbi.nlm.nih.gov