**Abstract**

This chapter reviews the issue of overweight management, which is one of the major challenges faced by most countries today. The causes of obesity include genetic and epigenetic factors, a lack of physical activity, eating disorders, and gut microbiota status. Physical exercise is the main means of prevention and management of overweight and obesity. The effectiveness of exercise programs for obese people typically varies around 80%, but it can be increased by taking into account biochemical, genetic, epigenetic, and microbiome markers, which allows choosing the most appropriate type of exercise according to individual characteristics. The pathogenetic preconditions for reducing exercise tolerance were examined based on the existing imbalance of adipokines, cytokines, and incretins. The association between genotype and weight loss induced by different diets and types of exercise was discussed along with obesity epigenetic markers. The effects of dietary choice on the microbiome composition and its contribution to the development of systemic inflammation in obese people were assessed. The weight management exercise program for middleaged women was presented. The structure and value of the factors that determine the physical condition of overweight middle-aged women were described. These data provide the basis for designing a sound exercise program for weight management.

**Keywords:** gene polymorphisms, obesity, exercise training, personalized approach, health-enhancing physical exercise
