Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

The role of physical activity in producing and maintaining weight loss

Abstract

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

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.

from$8.99

All prices are NET prices.

References

  1. 1

    Ogden CL et al. (2006) Prevalence of overweight and obesity in the United States, 1999–2004. JAMA 295: 1549–1555

    CAS  Article  Google Scholar 

  2. 2

    Anderssen S et al. (1995) Diet and exercise intervention have favourable effects on blood pressure in mild hypertensives: the Oslo Diet and Exercise Study (ODES). Blood Press 4: 343–349

    CAS  Article  Google Scholar 

  3. 3

    Binder EF et al. (1996) Effects of endurance exercise and hormone replacement therapy on serum lipids in older women. J Am Geriatr Soc 44: 231–236

    CAS  Article  Google Scholar 

  4. 4

    Cox KL et al. (2004) Independent and additive effects of energy restriction and exercise on glucose and insulin concentrations in sedentary overweight men. Am J Clin Nutr 80: 308–316

    CAS  Article  Google Scholar 

  5. 5

    Donnelly JE et al. (2003) Effects of a 16-month randomized controlled exercise trial on body weight and composition in young, overweight men and women: the Midwest Exercise Trial. Arch Intern Med 163: 1343–1350

    Article  Google Scholar 

  6. 6

    Hellenius ML et al. (1993) Diet and exercise are equally effective in reducing risk for cardiovascular disease. Results of a randomized controlled study in men with slightly to moderately raised cardiovascular risk factors. Atherosclerosis 103: 81–91

    CAS  Article  Google Scholar 

  7. 7

    Irwin ML et al. (2003) Effect of exercise on total and intra-abdominal body fat in postmenopausal women: a randomized controlled trial. JAMA 289: 323–330

    Article  Google Scholar 

  8. 8

    King AC et al. (1991) Group- vs home-based exercise training in healthy older men and women. A community-based clinical trial. JAMA 266: 1535–1542

    CAS  Article  Google Scholar 

  9. 9

    Kohrt WM et al. (1997) Effects of exercise involving predominantly either joint-reaction or ground-reaction forces on bone mineral density in older women. J Bone Miner Res 12: 1253–1261

    CAS  Article  Google Scholar 

  10. 10

    Pritchard JE et al. (1997) A worksite program for overweight middle-aged men achieves lesser weight loss with exercise than with dietary change. J Am Diet Assoc 97: 37–42

    CAS  Article  Google Scholar 

  11. 11

    Ready AE et al. (1995) Walking program reduces elevated cholesterol in women postmenopause. Can J Cardiol 11: 905–912

    CAS  PubMed  Google Scholar 

  12. 12

    Stefanick ML et al. (1998) Effects of diet and exercise in men and postmenopausal women with low levels of HDL cholesterol and high levels of LDL cholesterol. N Engl J Med 339: 12–20

    CAS  Article  Google Scholar 

  13. 13

    Stewart KJ et al. (2005) Exercise and risk factors associated with metabolic syndrome in older adults. Am J Prev Med 28: 9–18

    Article  Google Scholar 

  14. 14

    Tessier D et al. (2000) Effects of aerobic physical exercise in the elderly with type 2 diabetes mellitus. Arch Gerontol Geriatr 31: 121–132

    CAS  Article  Google Scholar 

  15. 15

    Verity LS and Ismail AH (1989) Effects of exercise on cardiovascular disease risk in women with NIDDM. Diabetes Res Clin Pract 6: 27–35

    CAS  Article  Google Scholar 

  16. 16

    Wood PD et al. (1983) Increased exercise level and plasma lipoprotein concentrations: a one-year, randomized, controlled study in sedentary, middle-aged men. Metabolism 32: 31–39

    CAS  Article  Google Scholar 

  17. 17

    Wood PD et al. (1988) Changes in plasma lipids and lipoproteins in overweight men during weight loss through dieting as compared with exercise. N Engl J Med 319: 1173–1179

    CAS  Article  Google Scholar 

  18. 18

    Slentz CA et al. (2004) Effects of the amount of exercise on body weight, body composition, and measures of central obesity: STRRIDE—a randomized controlled study. Arch Intern Med 164: 31–39

    Article  Google Scholar 

  19. 19

    Ballor DL and Keesey RE (1991) A meta-analysis of the factors affecting exercise-induced changes in body mass, fat mass and fat-free mass in males and females. Int J Obes 15: 717–726

    CAS  PubMed  Google Scholar 

  20. 20

    Garrow JS and Summerbell CD (1995) Meta-analysis: effect of exercise, with or without dieting, on the body composition of overweight subjects. Eur J Clin Nutr 49: 1–10

    CAS  PubMed  Google Scholar 

  21. 21

    Miller WC et al. (1997) A meta-analysis of the past 25 years of weight loss research using diet, exercise or diet plus exercise intervention. Int J Obes Relat Metab Disord 21: 941–947

    CAS  Article  Google Scholar 

  22. 22

    Wing RR (1999) Physical activity in the treatment of the adulthood overweight and obesity: current evidence and research issues. Med Sci Sports Exerc 31: S547–S552

    CAS  Article  Google Scholar 

  23. 23

    Lee L et al. (1994) The impact of five-month basic military training on the body weight and body fat of 197 moderately to severely obese Singaporean males aged 17 to 19 years. Int J Obes Relat Metab Disord 18: 105–109

    CAS  PubMed  Google Scholar 

  24. 24

    Hadjiolova I et al. (1982) Physical working capacity in obese women after an exercise programme for body weight reduction. Int J Obes 6: 405–410

    CAS  PubMed  Google Scholar 

  25. 25

    Ross R et al. (2004) Exercise-induced reduction in obesity and insulin resistance in women: a randomized controlled trial. Obes Res 12: 789–798

    Article  Google Scholar 

  26. 26

    Ross R et al. (2000) Reduction in obesity and related comorbid conditions after diet-induced weight loss or exercise-induced weight loss in men. A randomized, controlled trial. Ann Intern Med 133: 92–103

    CAS  Article  Google Scholar 

  27. 27

    Donnelly JE and Smith BK (2005) Is exercise effective for weight loss with ad libitum diet? Energy balance, compensation, and gender differences. Exerc Sport Sci Rev 33: 169–174

    Article  Google Scholar 

  28. 28

    Ross R et al. (1995) Effects of energy restriction and exercise on skeletal muscle and adipose tissue in women as measured by magnetic resonance imaging. Am J Clin Nutr 61: 1179–1185

    CAS  Article  Google Scholar 

  29. 29

    Ross R et al. (1996) Influence of diet and exercise on skeletal muscle and visceral adipose tissue in men. J Appl Physiol 81: 2445–2455

    CAS  Article  Google Scholar 

  30. 30

    Kohrt WM et al. (1992) Exercise training improves fat distribution patterns in 60- to 70-year-old men and women. J Gerontol 47: M99–M105

    CAS  Article  Google Scholar 

  31. 31

    Schwartz RS et al. (1991) The effect of intensive endurance exercise training on body fat distribution in young and older men. Metabolism 40: 545–551

    CAS  Article  Google Scholar 

  32. 32

    Katzmarzyk PT et al. (2003) Targeting the metabolic syndrome with exercise: evidence from the HERITAGE Family Study. Med Sci Sports and Exerc 35: 1703–1709

    CAS  Article  Google Scholar 

  33. 33

    Ashutosh K et al. (1997) Effects of sustained weight loss and exercise on aerobic fitness in obese women. J Sports Med Phys Fitness 37: 252–257

    CAS  PubMed  Google Scholar 

  34. 34

    Bertram SR et al. (1990) Weight loss in obese women—exercise v. dietary education. S Afr Med J 78: 15–18

    CAS  PubMed  Google Scholar 

  35. 35

    Hammer RL et al. (1989) Calorie-restricted low-fat diet and exercise in obese women. Am J Clin Nutr 49: 77–85

    CAS  Article  Google Scholar 

  36. 36

    Layman DK et al. (2005) Dietary protein and exercise have additive effects on body composition during weight loss in adult women. J Nutr 135: 1903–1910

    CAS  Article  Google Scholar 

  37. 37

    Lemons AD et al. (1989) Selection of appropriate exercise regimens for weight reduction during VLCD and maintenance. Int J Obes 13 (Suppl 2): 119–123

    PubMed  Google Scholar 

  38. 38

    Marks BL et al. (1995) Fat-free mass is maintained in women following a moderate diet and exercise program. Med Sci Sports Exerc 27: 1243–1251

    CAS  Article  Google Scholar 

  39. 39

    Nicklas BJ et al. (1997) Exercise blunts declines in lipolysis and fat oxidation after dietary-induced weight loss in obese older women. Am J Physiol 273: E149–E155

    CAS  PubMed  Google Scholar 

  40. 40

    Sweeney ME et al. (1993) Severe vs moderate energy restriction with and without exercise in the treatment of obesity: efficiency of weight loss. Am J Clin Nutr 57: 127–134

    CAS  Article  Google Scholar 

  41. 41

    Van Aggel-Leijssen DP et al. (2002) Long-term effects of low-intensity exercise training on fat metabolism in weight-reduced obese men. Metabolism 51: 1003–1010

    CAS  Article  Google Scholar 

  42. 42

    Wadden TA et al. (1997) Exercise in the treatment of obesity: effects of four interventions on body composition, resting energy expenditure, appetite, and mood. J Consult Clin Psychol 65: 269–277

    CAS  Article  Google Scholar 

  43. 43

    Wood PD et al. (1991) The effects on plasma lipoproteins of a prudent weight-reducing diet, with or without exercise, in overweight men and women. N Engl J Med 325: 461–466

    CAS  Article  Google Scholar 

  44. 44

    Borg P et al. (2002) Effects of walking or resistance training on weight loss maintenance in obese, middle-aged men: a randomized trial. Int J Obes Relat Metab Disord 26: 676–683

    CAS  Article  Google Scholar 

  45. 45

    Fogelholm M et al. (2000) Effects of walking training on weight maintenance after a very-low-energy diet in premenopausal obese women: a randomized controlled trial. Arch Intern Med 160: 2177–2184

    CAS  Article  Google Scholar 

  46. 46

    Leermakers EA et al. (1999) Effects of exercise-focused versus weight-focused maintenance programs on the management of obesity. Addict Behav 24: 219–227

    CAS  Article  Google Scholar 

  47. 47

    Pavlou KN et al. (1989) Exercise as an adjunct to weight loss and maintenance in moderately obese subjects. Am J Clin Nutr 49: 1115–1123

    CAS  Article  Google Scholar 

  48. 48

    Perri MG et al. (1986) Enhancing the efficacy of behavior therapy for obesity: effects of aerobic exercise and a multicomponent maintenance program. J Consult Clin Psychol 54: 670–675

    CAS  Article  Google Scholar 

  49. 49

    Perri MG et al. (1988) Effects of four maintenance programs on the long-term management of obesity. J Consult Clin Psychol 56: 529–534

    CAS  Article  Google Scholar 

  50. 50

    Sikand G et al. (1988) Two-year follow-up of patients treated with a very-low-calorie diet and exercise training. J Am Diet Assoc 88: 487–488

    CAS  PubMed  Google Scholar 

  51. 51

    Skender ML et al. (1996) Comparison of 2-year weight loss trends in behavioral treatments of obesity: diet, exercise, and combination interventions. J Am Diet Assoc 96: 342–346

    CAS  Article  Google Scholar 

  52. 52

    van Dale D et al. (1990) Weight maintenance and resting metabolic rate 18-40 months after a diet/exercise treatment. Int J Obes 14: 347–359

    CAS  PubMed  Google Scholar 

  53. 53

    Wadden TA et al. (1998) Exercise and the maintenance of weight loss: 1-year follow-up of a controlled clinical trial. J Consult Clin Psychol 66: 429–433

    CAS  Article  Google Scholar 

  54. 54

    Wing RR et al. (1988) Exercise in a behavioural weight control programme for obese patients with Type 2 (non-insulin-dependent) diabetes. Diabetologia 31: 902–909

    CAS  Article  Google Scholar 

  55. 55

    Wing RR et al. (1998) Lifestyle intervention in overweight individuals with a family history of diabetes. Diabetes Care 21: 350–359

    CAS  Article  Google Scholar 

  56. 56

    Curioni CC and Lourenco PM (2005) Long-term weight loss after diet and exercise: a systematic review. Int J Obes 29: 1168–1174

    CAS  Article  Google Scholar 

  57. 57

    Fogelholm M and Kukkonen-Harjula K (2000) Does physical activity prevent weight gain—a systematic review. Obes Rev 1: 95–111

    CAS  Article  Google Scholar 

  58. 58

    Kayman S et al. (1990) Maintenance and relapse after weight loss in women: behavioral aspects. Am J Clin Nutr 52: 800–807

    CAS  Article  Google Scholar 

  59. 59

    Hartman WM et al. (1993) Long-term maintenance of weight loss following supplemented fasting. Int J Eat Disord 14: 87–93

    CAS  Article  Google Scholar 

  60. 60

    Klem ML et al. (1997) A descriptive study of individuals successful at long-term maintenance of substantial weight loss. Am J Clin Nutr 66: 239–246

    CAS  Article  Google Scholar 

  61. 61

    Schoeller DA et al. (1997) How much physical activity is needed to minimize weight gain in previously obese women? Am J Clin Nutr 66: 551–556

    CAS  Article  Google Scholar 

  62. 62

    Weinsier RL et al. (2002) Free-living activity energy expenditure in women successful and unsuccessful at maintaining a normal body weight. Am J Clin Nutr 75: 499–504

    CAS  Article  Google Scholar 

  63. 63

    Jakicic JM et al. (1999) Effects of intermittent exercise and use of home exercise equipment on adherence, weight loss, and fitness in overweight women: a randomized trial. JAMA 282: 1554–1560

    CAS  Article  Google Scholar 

  64. 64

    Jakicic JM et al. (2003) Effect of exercise duration and intensity on weight loss in overweight, sedentary women: a randomized trial. JAMA 290: 1323–1330

    CAS  Article  Google Scholar 

  65. 65

    Jeffery RW et al. (2003) Physical activity and weight loss: does prescribing higher physical activity goals improve outcome? Am J Clin Nutr 78: 684–689

    CAS  Article  Google Scholar 

  66. 66

    Wilmore JH et al. (1998) Alterations in resting metabolic rate as a consequence of 20 wk of endurance training: the HERITAGE Family Study. Am J Clin Nutr 68: 66–71

    CAS  Article  Google Scholar 

  67. 67

    Bell C et al. (2004) High energy flux mediates the tonically augmented β-adrenergic support of resting metabolic rate in habitually exercising older adults. J Clin Endocrinol Metab 89: 3573–3578

    CAS  Article  Google Scholar 

  68. 68

    Van Pelt RE et al. (1997) Regular exercise and the age-related decline in resting metabolic rate in women. J Clin Endocrinol Metab 82: 3208–3212

    CAS  PubMed  Google Scholar 

  69. 69

    Bell C et al. (2003) Influence of adiposity on tonic sympathetic support of resting metabolism in healthy adults. Int J Obes Relat Metab Disord 27: 1315–1318

    CAS  Article  Google Scholar 

  70. 70

    Bell C et al. (2001) Tonic sympathetic support of metabolic rate is attenuated with age, sedentary lifestyle, and female sex in healthy adults. J Clin Endocrinol Metab 86: 4440–4444

    CAS  Article  Google Scholar 

  71. 71

    Poehlman ET et al. (1992) Influence of aerobic capacity, body composition, and thyroid hormones on the age-related decline in resting metabolic rate. Metabolism 41: 915–921

    CAS  Article  Google Scholar 

  72. 72

    Poehlman ET et al. (1991) Relation of age and physical exercise status on metabolic rate in younger and older healthy men. J Gerontol 46: B54–B58

    CAS  Article  Google Scholar 

  73. 73

    Mayer J et al. (1956) Relation between caloric intake, body weight, and physical work: studies in an industrial male population in West Bengal. Am J Clin Nutr 4: 169–175

    CAS  Article  Google Scholar 

  74. 74

    Kempen KP et al. (1995) Energy balance during an 8-wk energy-restricted diet with and without exercise in obese women. Am J Clin Nutr 62: 722–729

    CAS  Article  Google Scholar 

  75. 75

    Jakicic JM et al. (2002) Relationship of physical activity to eating behaviors and weight loss in women. Med Sci Sports Exerc 34: 1653–1659

    CAS  Article  Google Scholar 

  76. 76

    Saris WH et al. (2003) How much physical activity is enough to prevent unhealthy weight gain? Outcome of the IASO 1st Stock Conference and consensus statement. Obes Rev 4: 101–114

    CAS  Article  Google Scholar 

  77. 77

    Jakicic JM et al. (2001) American College of Sports Medicine position stand. Appropriate intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc 33: 2145–2156

    CAS  Article  Google Scholar 

Download references

Acknowledgements

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.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Victoria A Catenacci.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Catenacci, V., Wyatt, H. The role of physical activity in producing and maintaining weight loss. Nat Rev Endocrinol 3, 518–529 (2007). https://doi.org/10.1038/ncpendmet0554

Download citation

Further reading

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing