Sungeun Park , Jaemyun Ko
DOI:10.46695/ASCS.7.1.3
Abstract
PURPOSE This integrative review synthesized evidence on the metabolic health benefits of moderate- and high-intensity aerobic exercise in obese women and women with normal-weight obesity (NWO), and aimed to delineate response patterns by group characteristics and derive practical implications for intensity-based exercise prescription. METHOD Drawing on randomized controlled trials and systematic reviews/meta-analyses involving obese women and women with NWO, we narratively integrated findings across domains of glucose metabolism and insulin resistance, central adiposity (waist circumference and abdominal fat), lipid profiles, cardiorespiratory fitness, and supportive biomarkers (adipokines). RESULT Moderate-intensity aerobic exercise served as a foundational prescription, with repeatedly reported evidence linking it to improved insulin resistance and reduced abdominal/visceral fat, alongside high sustainability. High-intensity aerobic exercise―particularly high-intensity interval training (HIIT)―accumulated evidence for time-efficient improvements in glucose-related outcomes and VO₂max, and may elicit intensity-sensitive responses in HDL-C. However, the relative superiority of exercise intensity varied according to baseline metabolic status, fat distribution, intervention duration, interval configuration, total exercise dose, and co-interventions. Adipokines, especially adiponectin, exhibited inconsistent changes; therefore, interpreting them as supportive rather than standalone primary endpoints was considered appropriate. CONCLUSION In obese and NWO women, exercise intensity is an important determinant of metabolic health outcomes; however, effective prescription should prioritize individualized program design that integrates target outcomes, baseline risk, total exercise dose and sustainability, and safety―rather than assuming a uniform superiority of a given intensity. In NWO, weight-centered evaluation should be avoided, with priority given to assessments of body composition, abdominal fat, and glucose-related markers; resistance training may be considered when appropriate.
Key Words
Exercise Intensity, Moderate-Intensity Aerobic Exercise, High-Intensity Interval Training Obesity, Normal-Weight Obesity