What struck me about this article is that the inflammation and obesity trial subjects had a greater than average % adverse events. While it may be a dilemma for physicians to tell/advise individual patients if exercise is risky, these data suggest to me that obesity likely worsens inflammation due to exercise. The stress on the body is worse due to weight, and anti-inflammatory cytokines have more tissue to handle. Thus, unlike Extreme Makeover - Weight Loss edition, it may be more prudent to focus on diet first to reduce risk, and then exercise to control weight. It will be interesting to see if such a sequential approach is better, or if bariatric surgery has comparable outcomes without the adverse events.
