**1. Introduction**

Obesity is one of the main causes of death around the world. There has been a significant global increase in obesity rate during the last decades. This problem represents a global phenomenon occurring in all parts of the world region except parts of sub-Saharan Asia and Africa [1]. Moreover, this complex and undesirable clinical condition is a high- risk factor for various non-communicable diseases, such as, type 2 diabetes, cardiovascular disease, metabolic syndrome (MetSy), chronic kidney disease, hyperlipidemia, hypertension, nonalcoholic fatty liver disease, obstructive sleep apnea, osteoarthritis, and certain types of cancers [2, 3].

There are several possible mechanisms leading to obesity. The main cause is the significantly more excess energy stored in fat cells than the energy the body needs. This set characterizes the obesity disease [2, 4]. Research of Sacks et al. [5] showed that the food sources and quality of nutrients matter more than their quantity in the diet contributes for weight imbalance. The pathogenesis of obesity involves regulation of calorie utilization, appetite and physical activity, but have complex interactions with availability of health-care systems, the role of socio-economic status, and underlying hereditary and environmental factors [6].

Considering the cardiometabolic risk (CMR), the relationship between obesity and CMR is well-established, and the location of adipose tissue (AT), particularly in the abdominal region, is considered an important predictor of metabolic dysfunction than total fat mass [7, 8]. In obesity, the central obesity (CO) is characterized by the excess accumulation of AT in the abdominal region. The CO is strongly and independently correlated with MetSy and is assessed through the measurement of the waist circumference (WC) [8, 9].

As it is indicated in **Figure 1**, CO can be related to abdominal subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) [10]. The relationship between SAT and CMR is not still clear, but, the VAT has been considered a unique pathogenic fat depot.

It is suggested that VAT would be a metabolic organ that would regulate fat mass, and glucose and nutrient homeostasis. VAT is also an active endocrine organ that synthesizes and secretes numerous bioactive mediators, adipocytokines/adipokines, and other vasoactive substances [11, 12]. These adipocytokines/adipokines act on various organs with metabolic importance, such as liver and skeletal muscle. There is evidence of the roles of adipocytokines/adipokines in the regulation of metabolic disorders like diabetes, obesity and insulin resistance. VAT is associated strongly with CMR independent of overall body mass index (BMI) or total body adiposity [13–15].

The growth of the economy in the world, mechanized transport, urbanization, industrialization, an increasingly sedentary lifestyle, and a nutritional transition to processed foods with high-calorie diets have favored the increase of the prevalence of obesity. Moreover, the rising prevalence of childhood obesity suggests a burden of this disease in the healthcare systems in the future [16].

In this context, it would be important to identify clinical interventions that could be used to improve the management of individuals with obesity. Considering that the relationship between CO and impaired growth hormone (GH) secretion, it is still poorly understood [17, 18], but the relevance of the exercise, as an intervention to improve the GH secretion has been highlighted [19–21].

Exercise and diet modification can be considered as therapies for the management of obesity. Verheggen et al. [19] reported that while exercise is less effective than diet for body mass loss, exercise would promote superior reductions in VAT. Moreover, Berryman and List [20] reinforce that this finding may partly be explained by exercise-induced changes in lipolytic hormones, such as GH, during and after exercise, which seem to target VAT.

**Figure 1.** *Central obesity and subcutaneous and visceral adipose tissue.*

Putting together these considerations, the aim of this chapter is to integrate knowledge about the relevance of exercises and/or GH to the management of individuals with obesity.
