Is regular exercise an effective strategy for weight loss maintenance?

Abstract

Weight regain after weight loss is one of the most significant challenges to successful obesity treatment. Regular exercise has long been touted as a strategy for weight loss maintenance, but the lack of clear evidence in clinical trials has caused some to question its effectiveness. In this review, we present the arguments both questioning and in support of exercise as an obesity therapeutic. Our purpose is to bring clarity to the literature, present a unified perspective, and identify the gaps in knowledge that need to be addressed in future studies. Critical questions remain including sex differences, individual variability and compensatory behaviors in response to exercise, exercise adherence, the role of energy flux and the molecular mechanisms mediating the beneficial effects of exercise after weight loss and during weight regain. Future research should focus on these critical questions to provide a more complete understanding of the potential benefits of exercise on weight loss maintenance.

Gender‐specific considerations in physical activity, thermogenesis and fat oxidation: implications for obesity management

“…Coupled with an increasing prevalence and risk of cardiometabolic comorbidities, current obesity management and prevention strategies are proving to be largely ineffective in women, with more women than men actively trying to lose weight , yet women having more difficulty and generally losing less weight during weight management programmes . As such, understanding this gender disparity is key to the effective management and prevention of obesity and cardiometabolic disease in women.…”

Exercise in the management of obesity

“…In a recent review, Foright and coworkers [46] presented, in a comprehensive manner, the arguments questioning and supporting the effectiveness of exercise for weight loss maintenance. In favor of questioning, the authors cited the lack of clear evidence from RCTs, compensatory behaviors after exercise (such as increase in food consumption or decrease in free-living physical activity), high interindividual variability in the responses to exercise, and extremely low compliance to exercise recommendations, coupled to very low adherence to exercise regimes.…”

“…In favor of questioning, the authors cited the lack of clear evidence from RCTs, compensatory behaviors after exercise (such as increase in food consumption or decrease in free-living physical activity), high interindividual variability in the responses to exercise, and extremely low compliance to exercise recommendations, coupled to very low adherence to exercise regimes. Conversely, the abundance of evidence from prospective observational studies and retrospective correlations, practical issues (mainly lack of adherence and lack of exercise supervision) that make it extremely difficult to establish causative relationships through RCTs, and evidence supporting that the physiological effects of exercise counter adaptive responses to weight loss that favor weight regain, make it impossible to rule exercise out of any strategy promoting weight maintenance [46].…”

“…The most recent report by the National Institutes of Health working group on weight loss maintenance suggests that, regarding exercise, further research should focus on two main areas: (i) deepening our understanding of the mechanisms by which exercise can counter the biological factors that cause weight regain, and (ii) understanding factors that influence and promote long-term adherence to exercise prescription [33]. Future studies also need to focus on matters such as interindividual variability in the responses to exercise (for example, why there are "responders" and "non-responders", or "high responders" and "low responders"), sex differences, factors influencing compensatory behavior after exercise, and the molecular mechanisms behind the effects of exercise on energy flux and weight regulation [33,46].…”

Daily running exercise may induce incomplete energy intake compensation: a 7-day crossover trial

“…Body weight is often well regulated via various behavioral and physiological compensatory mechanisms (Martin et al 2019). Manipulating individual components of energy balance leads to compensatory alterations in the remaining components (Foright et al 2018;Silva et al 2019). Considering energy intake (EI) compensation, a single bout of moderate-to-vigorous aerobic exercise does not result in increased EI for up to two days post-exercise (King et al 1997;Douglas et al 2015;King et al 2015).…”