In fact, the USA spends twice as much on healthcare per capita compared to similarly developed, high-income countries. The economic ramifications associated with obesity are also significant, as health expenditures in the USA reached $3.6 trillion in 2018. Despite these well-known benefits, upwards of 80% of US adults do not meet the physical activity guidelines which highlights the need for effective programmes to increase physical activity. Additionally, studies have demonstrated the mental health benefits of engaging in physical activity, citing increases in anxiety and depression among individuals with low activity levels and improvements in overall self-reported mental health status among those who are physically active. For example, meeting these weekly physical activity guidelines can reduce the risk of cardiovascular and metabolic disease, cognitive decline and aid in the treatment of other chronic diseases (e.g. The US Department of Health and Human Services and the American College of Sports Medicine recommend 150 min per week of moderate intensity physical activity, 75 min per week of vigorous intensity physical activity or a combination of the two to achieve substantial health benefits.

Although obesity-related chronic diseases are currently the leading cause of death among Americans, physical activity is a modifiable health behaviour that is shown to prevent and treat various obesity-related chronic diseases. Similarly, adults with a BMI > 30 have a 50вЂ“100% increased risk for developing cardiovascular disease. Prior studies have shown a 28-fold increased risk for diabetes among those with a body mass index (BMI) > 30 and a 93-fold increase for those with a BMI > 35. Risks associated with obesity include hypertension, cardiovascular disease, type 2 diabetes and dyslipidaemias. An increase in sedentary jobs, easy access to high-caloric foods and insufficient amounts of physical activity has led to an increase in obesity rates over the three decades, with current prevalence rates reaching close to 40% compared to 12% three decades ago. Obesity is a significant and growing public health concern in the USA.

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