Original Article

International Journal of Obesity (2006) 30, 697–703. doi:10.1038/sj.ijo.0803185; published online 29 November 2005

A physical activity program to reinforce weight maintenance following a behavior program in overweight/obese subjects

N Villanova1, F Pasqui1, S Burzacchini1, G Forlani1, R Manini1, A Suppini1, N Melchionda1 and G Marchesini1

1Department Internal Medicine and Gastroenterology, Unit of Metabolic Diseases, 'Alma Mater Studiorum' University of Bologna, Bologna, Italy

Correspondence: Professor G Marchesini, Department Internal Medicine and Gastroenterology, Unit of Metabolic Diseases, 'Alma Mater Studiorum', University of Bologna, Policlinico S. Orsola, Via Massarenti 9, I-40138 Bologna, Italy. E-mail: giulio.marchesini@unibo.it

Received 25 May 2005; Revised 30 August 2005; Accepted 16 September 2005; Published online 29 November 2005.

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Abstract

Objective:

 

To investigate the effects of a specific program to implement physical activity (fitness program) on weight loss maintenance, activity level and resting energy expenditure (REE).

Design:

 

Observational study of subjects completing a behavioral program.

Subjects:

 

In total, 200 overweight/obese subjects (36 males, aged 20–66 years; average BMI, 35.2 kg/m2).

Program and measurements:

 

The fitness program consisted of 12 bimonthly sessions, chaired by doctors and dietitians, involving groups of 8–12 subjects. Patients entered the program approximately 9 months after the end of behavioral treatment, during a weight loss maintenance period. The goal was set at a light-to-moderate daily physical activity (brisk walking), quantitatively measured by a pedometer; REE was measured before and after the fitness program by indirect calorimetry in a subset of patients.

Results:

 

The fitness program restarted the process of weight loss in over 60% of subjects. At the end of the study, 84% of patients walked at least 5000 steps per day, compared with 24% at the beginning of the study. The probability of losing from 5 to 10% of initial body weight increased by 20% for any 1000 steps/day (OR, 1.20; 95% CI (confidence interval), 1.07–1.35), and that of losing more than 10% by over 30% (OR, 1.33; 95% CI, 1.19–1.49). REE increased significantly by 100 kcal/day (+7.5%), in spite of further weight loss (-1.8%).

Conclusion:

 

A specific fitness program in the weight maintenance phase after a behavioral program may significantly improve the long-term control of obesity.

Keywords:

behavior therapy, indirect calorimetry, pedometer, physical fitness, weight loss maintenance, metabolic syndrome

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