Effects of exercise-focused versus weight-focused maintenance programs on the management of obesity

Leermakers, Elizabeth A.; Perri, Michael G.; Shigaki, Cheryl L.; Fuller, Pamela R.

doi:10.1016/s0306-4603(98)00090-2

Cited by 71 publications

(84 citation statements)

References 27 publications

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“…The drop-out rate in our study was 24%, which was greater than in our previous study 14 and study by Leermakers et al, 22 but similar as in study by Perri et al 21 Due to decreased sample size the decreased statistical power is a weakness in our study. However, we were able to detect a 3.0 kg difference in body fat mass between R and C during maintenance phase.…”

Section: Discussionsupporting

confidence: 57%

“…However, maintenance of weight loss was not improved in the exercise group after 18 months of follow-up. In a study by Leermakers et al 22 an exercisefocused approach to WM resulted in greater weight regain than weight-focused approach. In our previous study obese women were randomized after weight loss into groups of diet, moderate amount of walking (target activity 4.2 MJ=week) and large amount of walking (8.4 MJ=week).…”

Section: Discussionmentioning

confidence: 98%

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Effects of walking or resistance training on weight loss maintenance in obese, middle-aged men: a randomized trial

et al. 2002

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OBJECTIVE: To investigate whether walking or resistance training improves weight maintenance after weight loss when added to dietary counselling. DESIGN: Two months' weight reduction with very-low-energy-diet (VLED) followed by randomization into three groups (control, walking, resistance training) for 6 months' weight maintenance (WM) program and 23 months' unsupervised followup. During VLED and WM all groups received similar dietary counselling. SUBJECTS: The main inclusion criteria were BMI > 30 kg=m 2 , waist > 100 cm and physical inactivity (exercise once a week). Ninety healthy, obese (mean BMI 32.9 kg=m 2 and waist 112.5 cm), 35 -50 y-old men started the study and 68 were measured at the end of the study. MEASUREMENTS: Weight and body composition assessed by underwater weighing. Exercise diaries and dietary records to assess energy balance. RESULTS: During VLED the mean body weight decreased from 106.0 (s.d. 9.9) kg to 91.7 (9.4) kg. Weight was regained mostly during follow-up and in the end of the study the mean weight in groups was 99.9 -102.0 kg. Exercise training did not improve short or long-term weight maintenance when compared to the control group. However, resistance training attenuated the regain of body fat mass during WM (P ¼ 0.0l), but not during follow-up. In the combined groups the estimated total energy expenditure (EE) of reported physical activity was associated with less weight regain during WM. EE of 10.1 MJ=week was associated with maintaining weight after weight loss. EE of physical activity tended to decrease after WM in exercise groups due to poor long-term adherence to prescribed exercise. Energy intake seemed to increase during follow-up. CONCLUSION: Exercise training of moderate dose did not seem to improve long-term weight maintenance because of poor adherence to prescribed exercise.

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Section: Discussionsupporting

confidence: 57%

Section: Discussionmentioning

confidence: 98%

Effects of walking or resistance training on weight loss maintenance in obese, middle-aged men: a randomized trial

et al. 2002

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“…The maintenance of treatment-induced weight loss thus remains a significant challenge in the management of obesity. 9 Strategies to improve the maintenance of weight loss have resulted in behavior modification: changes in diet and increased physical activity. [9][10][11] These interventions show a great promise for improving long-term outcome.…”

Section: Introductionmentioning

confidence: 99%

“…9 Strategies to improve the maintenance of weight loss have resulted in behavior modification: changes in diet and increased physical activity. [9][10][11] These interventions show a great promise for improving long-term outcome. 9 To maintain weight loss, some people may prefer to change their dietary pattern, while others prefer to become more physically active.…”

Section: Introductionmentioning

confidence: 99%

Categorical strategies based on subject characteristics of dietary restraint and physical activity, for weight maintenance

Vogels

Westerterp-Plantenga

2005

Int J Obes

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OBJECTIVE:The aim of this study was to investigate the effect of categorical strategies based on subject-specific characteristics of dietary restraint and physical activity, on weight maintenance (WM) in overweight and obese subjects, after a very low calorie diet (VLCD). Furthermore, find predictors of WM that can be important in the context of obesity treatment. METHODS: In all, 120 subjects (age: 49.079.8 y, BMI 31.073.8 kg/m 2 ) followed a VLCD (2.1 MJ/day) for 6 weeks in a freeliving situation, followed by a period of 1 y WM. Body weight (BW), body composition, leptin concentration, dietary restraint and physical activity were determined right before (t0) and after (t1) the VLCD, after 3 months (t2) and after 1 y (t3). During WM, subjects were divided into four categories of WM guidelines (dietary, activity, diet þ activity, placebo), taking their capability measured during weight loss and their preference for particular guidelines into account. RESULTS: BW loss during VLCD was 7.073.1 kg. After 1 y follow-up, BW regain was 56.3755.0%, without significant differences between the four groups. With respect to measured capability during weight loss, subjects with an increased dietary restraint (F1 of the Three Factor Eating Questionnaire) had less BW regain than subjects with an increased physical activity (Baecke questionnaire) (35.5753.2 vs 68.5746.4%, Po0.05). Moreover, activity guidelines promoted WM in dietary disciplined subjects compared to activity-related disciplined subjects (%regain: 25.2 vs 74.3%, Po0.05). Subjects receiving guidelines that were opposite to their preference showed a better WM than subjects receiving preferred guidelines. After 1 y WM, 21 subjects were successful (o10% BW regain) and 99 unsuccessful (Z10% BW regain). At baseline, these groups were significantly different in BMI (resp. 32.774.9 vs 30.773.5 kg/m 2 , Po0.05), waist circumference (106.5714.0 vs 100.6711.2 cm, Po0.05) and fat mass (FM) (35.2710.6 vs 32.176.6%, P ¼ 0.06). Finally, successful subjects appeared to spare fat-free mass (FFM) to a greater extent than unsuccessful subjects. CONCLUSION: After weight loss, type of guidelines (dietary, activity, placebo) is not related to the magnitude of WM, whereas guidelines opposite to the subject's capability and preference are related. These only reach successful WM (490%) in originally dietary disciplined subjects who are supported by characteristics such as a relatively high baseline BMI, waist circumference and FM, together with the ability to spare FFM.

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“…53 Among the limited number of studies that have used experimental designs to examine the relationship between physical activity level and weight loss maintenance, the pattern of results has been less clear. 21,28,[54][55][56][57] In several studies, experimental condition did not produce differences in weight loss maintenance. However, across groups, participants who reported exercising the most typically experienced the greatest weight loss maintenance.…”

Section: Promoting High Levels Of Physical Activitymentioning

confidence: 96%

Behavioral Treatment of Obesity

Wadden¹,

Sarwer²

1999

The Management of Eating Disorders and Obesity

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SynopsisBehavioral treatment should be the first line of intervention for overweight and obese individuals. This paper provides an overview of the structure and principles of behavioral weight loss treatment. The short-and long-term effectiveness of this approach is reviewed. Strategies for improving weight loss maintenance are described, including prolonging contact between patients and providers (either in the clinic or via Internet or telephone), facilitating high amounts of physical activity, and combining lifestyle modification with pharmacotherapy. Finally, innovative programs that can be used to disseminate behavioral approaches beyond traditional academic settings are discussed. Keywords obesity; weight loss; dieting; lifestyle; behavioral Weight loss treatment is recommended for adults with a body mass index (BMI) of 30 kg/m 2 or higher, as well as those with BMI of 25 kg/m 2 or higher who have weight-related comorbidities. 1 Behavioral treatment should be the first line of intervention for overweight and obese individuals. 1 This paper first provides an overview of the structure and principles of behavioral weight loss treatment. Second, the short-and long-term effectiveness of this approach is reviewed. Third, strategies for improving weight loss maintenance are described. Finally, dissemination of behavioral treatment is addressed. Structures and principles of behavioral treatmentThe lifestyle modification interventions delivered in the Diabetes Prevention Program and Look AHEAD research studies are exemplars of behavioral treatment programs. 2,3 The intervention materials from both of these programs are in the public domain and may be used for educational or research purposes. Behavioral weight loss treatment also has been described in detail in other publications. [4][5][6] The structure and three key components of this © 2011 Elsevier Inc. All rights reserved. Meghan L. Butryn, Ph.D., mlb34@drexel.edu. Mailing address: Drexel University, 245 N. 15 th St., MS 626, Philadelphia, PA 19102. Phone: 215-762-3567. Fax: 215-762-7441. Victoria Webb, B.A., vwebb@mail.med.upenn.edu. Mailing address: Center for Weight and Eating Disorders, University of Pennsylvania, 3535 Market St., Philadelphia, PA 19104. Phone: 215-898-4793. Fax: 215-898-2878. Thomas A. Wadden, Ph.D., wadden@mail.med.upenn.edu. Mailing address: Center for Weight and Eating Disorders, University of Pennsylvania, 3535 Market St., Philadelphia, PA, 19104. Phone: 215-898-7315. Fax: 215-898-2878. Disclosures: The authors have no financial disclosures or conflicts of interest to declare.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers ...

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Effects of exercise-focused versus weight-focused maintenance programs on the management of obesity

Cited by 71 publications

References 27 publications

Effects of walking or resistance training on weight loss maintenance in obese, middle-aged men: a randomized trial

Effects of walking or resistance training on weight loss maintenance in obese, middle-aged men: a randomized trial

Categorical strategies based on subject characteristics of dietary restraint and physical activity, for weight maintenance

Behavioral Treatment of Obesity

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