L'importance de pratiquer une activité physique régulière n'est plus à démontrer dans la population générale et chez les patients en surcharge pondérale et/ou présentant des facteurs de risque cardio-vasculaires métaboliques. Il est cependant difficile d'augmenter le niveau d'activité physique d'un sujet obèse pour plusieurs raisons

Dans cet article, nous rappelons les effets thérapeutiques de l'exercice physique et nous rapportons les recommandations actuelles dans la population générale, chez les patients obèses et chez les patients présentant des anomalies métaboliques.

The beneficial role of regular physical exercise is well known in the general population and in overweight patients with or without metabolic cardiovascular risk factors. However, it is difficult to increase the activity level in overweight subjects for several reasons

• increasing the activity level requires a change of lifestyle;
• it is not rewarded by weight loss which decreases subject's compliance to exercise;
• severe obesity decrease the tolerance to exercise at higher intensity which contributes in the inability to continue regular physical exercise;
• we do not have in our health system specific structures that allow the prescription and the supervision of a physical activity program for patients at high cardiovascular risk.

In this article, we summarise the therapeutic effects of physical exercise and report current recommendations in the general population as well as in obese subjects and in patients with metabolic abnormalities.