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The role of physical activity in producing and maintaining weight loss


The majority of randomized, controlled trials (RCTs) show only modest weight loss with exercise intervention alone, and slight increases in weight loss when exercise intervention is added to dietary restriction. In most RCTs, the energy deficit produced by the prescribed exercise is far smaller than that usually produced by dietary restriction. In prospective studies that prescribed high levels of exercise, enrolled individuals achieved substantially greater weight loss—comparable to that obtained after similar energy deficits were produced by caloric restriction. High levels of exercise might, however, be difficult for overweight or obese adults to achieve and sustain. RCTs examining exercise and its effect on weight-loss maintenance demonstrated mixed results; however, weight maintenance interventions were usually of limited duration and long-term adherence to exercise was problematic. Epidemiologic, cross-sectional, and prospective correlation studies suggest an essential role for physical activity in weight-loss maintenance, and post hoc analysis of prospective trials shows a clear dose–response relationship between physical activity and weight maintenance. This article reviews the role of physical activity in producing and maintaining weight loss. We focus on prospective, RCTs lasting at least 4 months; however, other prospective trials, meta-analyses and large systematic reviews are included. Limitations in the current body of literature are discussed.

Key Points

  • Substantial weight loss can be achieved with physical activity alone when the appropriate volume of exercise is prescribed and energy intake is held constant but for many overweight or obese individuals this strategy is not sufficient as the volume of exercise required is difficult to achieve and sustain

  • Dietary restriction and increased physical activity in combination have generally been found to modestly improve weight loss compared with diet alone; however, overweight and obese individuals can lose large amounts of weight with dietary restriction alone

  • The addition of physical activity (60–90 min) to a dietary intervention substantially increases the odds of successful long-term weight-loss maintenance and might be essential for most overweight and obese individuals to maintain weight loss

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Désirée Lie, University of California, Irvine, CA, is the author of and is solely responsible for the content of the learning objectives, questions and answers of the Medscape-accredited continuing medical education activity associated with this article.

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Correspondence to Victoria A Catenacci.

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Catenacci, V., Wyatt, H. The role of physical activity in producing and maintaining weight loss. Nat Rev Endocrinol 3, 518–529 (2007).

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