Effect of Exercise on 24-Month Weight Loss Maintenance in Overweight Women

Physical Activity and Weight Management Research Center, University of Pittsburgh, 140 Trees Hall, Pittsburgh, PA 15261, USA.
Archives of internal medicine (Impact Factor: 17.33). 08/2008; 168(14):1550-9; discussion 1559-60. DOI: 10.1001/archinte.168.14.1550
Source: PubMed


Debate remains regarding the amount of physical activity that will facilitate weight loss maintenance.
Between December 1, 1999, and January 31, 2003, 201 overweight and obese women (body mass index [calculated as weight in kilograms divided by height in meters squared], 27 to 40; age range, 21-45 years) with no contraindications to weight loss or physical activity were recruited from a hospital-based weight loss research center. Participants were assigned to 1 of 4 behavioral weight loss intervention groups. They were randomly assigned to groups based on physical activity energy expenditure (1000 vs 2000 kcal/wk) and intensity (moderate vs vigorous). Participants also were told to reduce intake to 1200 to 1500 kcal/d. A combination of in-person conversations and telephone calls were conducted during the 24-month study period.
Weight loss did not differ among the randomized groups at 6 months' (8%-10% of initial body weight) or 24 months' (5% of initial body weight) follow-up. Post-hoc analysis showed that individuals sustaining a loss of 10% or more of initial body weight at 24 months reported performing more physical activity (1835 kcal/wk or 275 min/wk) compared with those sustaining a weight loss of less than 10% of initial body weight (P < .001).
The addition of 275 mins/wk of physical activity, in combination with a reduction in energy intake, is important in allowing overweight women to sustain a weight loss of more than 10%. Interventions to facilitate this level of physical activity are needed.

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Available from: John M Jakicic, Mar 18, 2015
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    • "In general, behavioral weight loss interventions have been successful in reducing weight among obese adults (e.g., [2] [3] [4]). According to the National Institute of Health clinical guidelines, behavioral weight loss interventions featuring diet (decreased energy intake), physical activity (increased energy expenditure ), and behavioral therapy (behavior modification) components typically result in approximately 5–10% weight loss after 6 months of intervention [2] [5] [6]. However, this degree of success is commonly not observed among African-American women [7] [8]. "
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    ABSTRACT: Despite the high prevalence of obesity among African American women and modest success in behavioral weight loss interventions, the development and testing of weight management interventions using a community-based participatory research (CBPR) approach has been limited. Doing Me: Sisters Standing Together for Healthy Mind and Body (Doing Me!) is an intervention adapted from an evidence-based behavioral obesity intervention using a CBPR approach. The purpose of Doing Me! is to test the feasibility and acceptability of this adapted intervention and determine its efficacy in achieving improvements in anthropometrics, diet, and physical activity. Sixty African American women, from a low-income, urban community, aged 30-65 years will be randomized to one of two arms: 16-week Doing Me! (n=30) or waitlist control (n=30). Doing Me! employs CBPR methodology to involve community stakeholders and members during the planning, development, implementation, and evaluation phases of the intervention. There will be thirty-two 90-minute sessions incorporating 45minutes of instruction on diet, physical activity, and/or weight management plus 45minutes of physical activity. Data will be collected at baseline and post-intervention (16weeks). Doing Me! is one of the first CBPR studies to examine the feasibility/acceptability of an adapted evidence-based behavioral weight loss intervention designed for obese African American women. CBPR may be an effective strategy for implementing a weight management intervention among this high-risk population. Copyright © 2015. Published by Elsevier Inc.
    Contemporary clinical trials 06/2015; 43. DOI:10.1016/j.cct.2015.06.006 · 1.94 Impact Factor
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    • "Jakicic et al. (2008) showed that in an intervention similar to ours, after a similar weight loss at 6 months, BW increased progressively to 24 months. The decrease in physical activity after month 6 and the lack of compliance with dietary recommendations may have contributed to regaining the BW (Jakicic et al. 2008). In the future, it would be interesting to use a longer intervention period and to determine the different factors that influence the dynamics of weight loss. "
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    ABSTRACT: The objective of this work was to evaluate how sex, age, and the kind of treatment followed affect weight loss in overweight men and women, as well as to develop an explanation for the evolution of weight-loss dynamics. The study consisted of 119 overweight participants (18-50 years old, body mass index >25 and <29.9 kg·m(-2)), who were randomly assigned to 1 of 4 treatment programs, namely, strength training (n = 30), endurance training (n = 30), a combination of strength training and endurance training (n = 30), and a careful treatment including diet and physical recommendations (n = 29). Each of the training groups exercised 3 times per week for 24 weeks, and their daily diet was restricted to a specific protocol during the testing period and controlled carefully. Body weight changes in the participants were evaluated every 15 days. Based on this study, we developed and validated different sets of equations to accurately capture the weight-loss dynamics. There were no significant differences in terms of global body weight changes from the statistical viewpoint, either regarding the carried out treatment or the individuals' ages. However, significant differences in weight-loss tendency were found depending on participant sex. We concluded that the effectiveness of different possible treatments for weight loss varies by sex and, based on our experimental observations, a quadratic function provides the most accurate model for capturing specific weight-loss dynamics. This trial is registered at Clinical Trials Gov.: number NCT01116856.
    Applied Physiology Nutrition and Metabolism 09/2013; 38(9):967-76. DOI:10.1139/apnm-2012-0441 · 2.34 Impact Factor
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    • "The importance of PA for improving long-term weight loss and minimizing weight regain is supported by the systematic review conducted for the 2009 American College of Sports Medicine Position Paper.16 Based on this review, weight maintenance is improved with PA >250 min/week, which is consistent with the results of empirical studies.63,64,67 Jeffery et al. evaluated the efficacy for long-term weight loss of recommendations for much higher PA than those normally used in behavioral treatments.67 "
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    ABSTRACT: Biological aging is typically associated with a progressive increase in body fat mass and a loss of lean body mass. Owing to the metabolic consequences of reduced muscle mass, it is understood that normal aging and/or decreased physical activity may lead to a higher prevalence of metabolic disorders. Lifestyle modification, specifically changes in diet, physical activity, and exercise, is considered the cornerstone of obesity management. However, for most overweight people it is difficult to lose weight permanently through diet or exercise. Thus, prevention of weight gain is thought to be more effective than weight loss in reducing obesity rates. A key question is whether physical activity can extenuate age-related weight gain and promote metabolic health in adults. Current guidelines suggest that adults should accumulate about 60 minutes of moderate-intensity physical activity daily to prevent unhealthy weight gain. Because evidence suggests that resistance training may promote a negative energy balance and may change body fat distribution, it is possible that an increase in muscle mass after resistance training may be a key mediator leading to better metabolic control.
    Annals of the New York Academy of Sciences 11/2012; 1281(1). DOI:10.1111/j.1749-6632.2012.06785.x · 4.38 Impact Factor
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