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: 13.25). 08/2008; 168(14):1550-9; discussion 1559-60. DOI: 10.1001/archinte.168.14.1550
Source: PubMed

ABSTRACT 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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    ABSTRACT: BACKGROUND. Roux-en-Y gastric bypass (RYGB) surgery causes profound weight loss and improves insulin sensitivity (51) in obese patients. Regular exercise can also improves S-1 in obese individuals; however, it is unknown whether exercise and RYGB surgery-induced weight loss would additively improve S-1 and other cardiometabolic factors. METHODS. We conducted a single-blind, prospective, randomized trial with 128 men and women who recently underwent RYGB surgery (within 1-3 months). Participants were randomized to either a 6-month semi-supervised moderate exercise protocol (EX, n = 66) or a health education control (CON; n = 62) intervention. Main outcomes measured included Si and glucose effectiveness (S-G), which were determined from an intravenous glucose tolerance test and minimal modeling. Secondary outcomes measured were cardiorespiratory fitness (VO2 peak) and body composition. Data were analyzed using an intention-to-treat (ITT) and per-protocol (PP) approach to assess the efficacy of the exercise intervention (>120 min of exercise/week). RESULTS. 119 (93%) participants completed the interventions, 95% for CON and 91% for EX. There was a significant decrease in body weight and fat mass for both groups.(P < 0.001 for time effect). S-1 improved in both groups following the intervention (ITT: CON vs. EX; +1.64 vs. +2.24 min(-1)/mu U/ml, P = 0.18 for Delta, P < 0.001 for time effect). A PP analysis revealed that exercise produced an additive S, improvement (PP: CON vs. EX; +1.57 vs. +2.69min(-1)/mu U/ml, P = 0.019) above that of surgery. Exercise also improved S-G (ITT: CON vs. EX; +0.0023 vs. +0.0063 min(-1), P = 0.009) compared with the CON group. Exercise improved cardiorespiratory fitness (VO2 peak) compared with the CON group. CONCLUSION. Moderate exercise following RYGB surgery provides additional improvements in S-1, S-G, and cardiorespiratory fitness compared with a sedentary lifestyle during similar weight loss.
    Journal of Clinical Investigation 12/2014; 125(1). DOI:10.1172/JCI78016 · 13.77 Impact Factor
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    ABSTRACT: The National Institutes of Health, led by the National Heart, Lung, and Blood Institute, organized a working group of experts to discuss the problem of weight regain after weight loss. A number of experts in integrative physiology and behavioral psychology were convened with the goal of merging their perspectives regarding the barriers to scientific progress and the development of novel ways to improve long-term outcomes in obesity therapeutics. The specific objectives of this working group were to: (1) identify the challenges that make maintaining a reduced weight so difficult; (2) review strategies that have been used to improve success in previous studies; and (3) recommend novel solutions that could be examined in future studies of long-term weight control. Specific barriers to successful weight loss maintenance include poor adherence to behavioral regimens and physiological adaptations that promote weight regain. A better understanding of how these behavioral and physiological barriers are related, how they vary between individuals, and how they can be overcome will lead to the development of novel strategies with improved outcomes. Greater collaboration and cross-talk between physiological and behavioral researchers is needed to advance the science and develop better strategies for weight loss maintenance. © 2014 The Obesity Society.
    Obesity 01/2015; 23(1). DOI:10.1002/oby.20967 · 4.39 Impact Factor
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    ABSTRACT: Objective To examine the amount of objectively measured MVPA and LPA that is associated with long-term weight loss and the maintenance of clinically significant weight loss.Methods Adults (N = 260; BMI: 25 to <40 kg/m2; age: 18–55 years) participated in an 18-month behavioral weight loss intervention and were prescribed a low-calorie diet and increased physical activity. Change in weight and objectively measured physical activity were assessed. MVPA > 10 (MET-min/week) was computed from bouts >10 min and >3.0 METs and MVPA < 10 was computed from bouts <10 min in duration and >3.0 METs. LPA was computed from bouts between 1.5 to <3.0 METs.ResultsWhen grouped on percent weight loss at 18 months, there was a significant group × time interaction effect (P < 0.0001) for both MVPA > 10 and LPA, with both measures being significantly greater at 18 months in those with >10% weight loss. Similar results were observed for MVPA > 10 and LPA with participants grouped on achieving >10% weight loss at 6 months and sustaining this at 18 months.ConclusionsMVPA > 10 of 200-300 min per week, coupled with increased amounts of LPA, are associated with improved long-term weight loss. Interventions should promote engagement in these amounts and types of physical activity.
    Obesity 11/2014; 22(11). DOI:10.1002/oby.20830 · 4.39 Impact Factor

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