A Randomized Trial Evaluating Exercise for the Prevention of Weight Regain

Abstract

Objective This study aimed to evaluate the effectiveness of three levels of exercise on weight regain subsequent to clinically meaningful weight loss (WL). Methods Adults with overweight or obesity (n = 298) initiated a 3‐month behavioral WL intervention, which included reduced energy intake, increased exercise, and weekly behavioral counseling. Participants achieving ≥5% WL (n = 235) began a 12‐month behavioral WL maintenance intervention and were randomized to 150 min/wk (n = 76), 225 min/wk (n = 80), or 300 min/wk (n = 79) of partially supervised moderate‐to‐vigorous–intensity exercise. Results Participants randomized to 150, 225, and 300 minutes of exercise completed 129 ± 30, 153 ± 49 and 179 ± 62 min/wk of exercise (supervised + unsupervised), respectively. Mean WL at 3 months (9.5 ± 3.1 kg) was similar across randomized groups (P = 0.68). Weight change across 12 months was 1.1 ± 6.5 kg, 3.2 ± 5.7 kg, and 2.8 ± 6.9 kg in the 150, 225, and 300 min/wk groups, respectively. Intent‐to‐treat analysis revealed no significant overall trend across the three treatment groups (P = 0.09), effects for group (P = 0.08), or sex (P = 0.21). Conclusions This study found no evidence for an association between the volume of moderate‐to‐vigorous–intensity exercise and weight regain across 12 months following clinically relevant WL. Further, results suggest that exercise volumes lower than those currently recommended for WL maintenance, when completed in conjunction with a behavioral weight‐maintenance intervention, may minimize weight regain over 12 months.

Effect of exercise training on weight loss, body composition changes, and weight maintenance in adults with overweight or obesity: An overview of 12 systematic reviews and 149 studies

“… 46 However, the recently published results of the METPOWeR trial that evaluated the effectiveness of three different volumes of aerobic exercise (i.e., 150, 225, and 300 min/week), in addition to a behavioral weight maintenance program, on the prevention of weight regain over 12 months after a ≥5% weight loss showed no significant difference in weight regain across exercise groups. 47 Overall, 88% of participants across groups maintained a 5% weight loss at 12 months, and the mean weight regain ranged from 1.1 kg in the low‐volume exercise group to 2.8 kg in the high‐volume exercise group. 47 Authors of this study conclude that minimal volume of exercise may favor successful weight maintenance, although the study was not designed to show equivalence between interventions.…”

“… 47 Overall, 88% of participants across groups maintained a 5% weight loss at 12 months, and the mean weight regain ranged from 1.1 kg in the low‐volume exercise group to 2.8 kg in the high‐volume exercise group. 47 Authors of this study conclude that minimal volume of exercise may favor successful weight maintenance, although the study was not designed to show equivalence between interventions. 47 Poor adherence to exercise protocols has been cited as the main reason why RCTs fail to demonstrate an effect of exercise on weight maintenance.…”

“… 47 Poor adherence to exercise protocols has been cited as the main reason why RCTs fail to demonstrate an effect of exercise on weight maintenance. 6 , 13 , 47 Finding effective strategies to improve patients' adherence to exercise is therefore required to provide more robust evidence on the effect of exercise on weight maintenance in participants with overweight or obesity, a crucial issue in long‐term obesity management.…”

Physical Activity, Weight Loss, and Weight Maintenance in the DiOGenes Multicenter Trial

“…Current recommendations vary between 200 and 450 min/week ( 15 , 24 , 25 ), but these are mainly based on cross-sectional, non-randomized and retrospective studies. A recently published RCT ( 26 ) compared the effects of three different partially supervised exercise programs (150, 220, or 300 min/week) in combination with weekly behavioral counseling on weight regain over 12 months after a weight loss program where participants had lost ≥5% of their initial weight. No difference in weight regain was found among the groups.…”

“…The lack of a control group does not allow conclusions about whether or how much weight regain was prevented. The authors concluded from these results that it is likely that less exercise is needed than currently recommended for prevention of weight regain ( 26 ). From the current study no conclusions can be drawn about the effective volume of self-selected PA, because the questionnaire used to assess PA does not allow quantification of the volume of PA.…”