Role of Physical Activity for Weight Loss and Weight Maintenance

Treatments to induce weight loss for the obese patient centre on the achievement of negative energy balance. This objective can theoretically be attained by interventions designed to achieve a reduction in energy intake and/or an increase in energy expenditure. Such ‘lifestyle interventions’ usually comprise one or more of the following strategies: dietary modification; behaviour change; increases in physical activity. These interventions are advocated as first treatment steps in algorithms recommended by current clinical obesity guidelines. Medication and surgical treatments are potentially available to those unable to implement ‘lifestyle interventions’ effectively by achieving losses of between 5 kg and 10 kg. It is accepted that the minimum of 5% weight loss is required to achieve clinically-meaningful benefits. Dietary treatments differ widely. Successful weight loss is most often associated with quantification of energy intake rather than macronutrient composition. Most dietary intervention studies secure a weight loss of between 5 kg and 10 kg after intervention for 6 months, with gradual weight regain at 1 year where weight changes are 3–4 kg below the starting weight. Some dietary interventions when evaluated at 2 and 4 years post intervention report the effects of weight maintenance rather than weight loss. Specific anti-obesity medications are effective adjuncts to weight loss, in most cases doubling the weight loss of those given dietary advice only. Greater physical activity alone increases energy expenditure by insufficient amounts to facilitate clinically-important weight losses, but is useful for weight maintenance. Weight losses of between half and three-quarters of excess body weight are seen at 10 years post intervention with bariatric surgery, making this arguably the most effective weight-loss treatment.

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Optimizing weight loss outcomes for bariatric surgery patients: the role of physical activity

BMC Proceedings ◽

10.1186/1753-6561-6-s4-o1 ◽

2012 ◽

Vol 6 (S4) ◽

Author(s):

R Boddu ◽

E Wilson ◽

B Snyder ◽

TD Wilson

Keyword(s):

Physical Activity ◽

Bariatric Surgery ◽

Weight Loss ◽

Weight Loss Outcomes

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

Frontiers in Nutrition ◽

10.3389/fnut.2021.683369 ◽

2021 ◽

Vol 8 ◽

Author(s):

Marleen A. van Baak ◽

Gabby Hul ◽

Arne Astrup ◽

Wim H. Saris

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Weight Maintenance ◽

Secondary Analysis ◽

Maintenance Phase ◽

Weight Loss Maintenance ◽

Multicenter Trial ◽

Matsuda Index ◽

Training Programmes ◽

Positive Effect

In this secondary analysis of the DiOGenes study, we investigated whether physical activity (PA) contributes to diet-induced weight loss and helps to reduce subsequent regain. We also studied the associations of PA with changes in cardiometabolic variables. Adults with overweight were included and followed an 8-week low-calorie diet (LCD). When successful (>8% weight loss), participants were randomized to different ad libitum diet groups and were advised to maintain their weight loss over the 6-month intervention period. Body weight (BW), body composition, cardiometabolic variables and subjectively-assessed PA were measured at baseline, at the end of weight loss and at the end of the intervention. BW was reduced by the LCD (from 99.8 ± 16.7 to 88.4 ± 14.9 kg; P < 0.001). This reduction was maintained during the weight maintenance period (89.2 ± 16.0 kg). Total PA (sum score of the three subscales of the Baecke questionnaire) increased during the weight loss period (from 8.16 ± 0.83 to 8.39 ± 0.78; P < 0.001) and this increase was subsequently maintained (8.42 ± 0.90). We found no evidence that baseline PA predicted weight loss. However, a higher level of baseline PA predicted a larger weight-loss-induced improvement in total cholesterol, triglycerides, glucose and CRP, and in post-prandial insulin sensitivity (Matsuda index). Subsequent weight and fat mass maintenance were predicted by the post-weight loss level of PA and associated with changes in PA during the weight maintenance phase. In conclusion, despite the fact that higher baseline levels of PA did not predict more weight loss during the LCD, nor that an increase in PA during the LCD was associated with more weight loss, higher PA levels were associated with more improvements in several cardiometabolic variables. The positive effect of higher PA on weight loss maintenance seems in contrast to randomized controlled trials that have not been able to confirm a positive effect of exercise training programmes on weight loss maintenance. This analysis supports the notion that higher self-imposed levels of PA may improve the cardiometabolic risk profile during weight loss and help to maintain weight loss afterwards.

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Role of Physical Activity in Surgical Weight Loss

Physical Activity and Obesity ◽

10.5040/9781492595731.ch-056 ◽

2015 ◽

Author(s):

Paul E. O’Brien

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Surgical Weight Loss

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Biochemical, Anthropometric and Lifestyle Factors Related with Weight Maintenance after Weight Loss Secondary to a Hypocaloric Mediterranean Diet

Annals of Nutrition and Metabolism ◽

10.1159/000484446 ◽

2017 ◽

Vol 71 (3-4) ◽

pp. 217-223 ◽

Cited By ~ 4

Author(s):

Daniel Antonio de Luis ◽

Olatz Izaola ◽

David Primo ◽

Hilda F. Ovalle ◽

Juan Jose Lopez ◽

...

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Mediterranean Diet ◽

Dietary Intervention ◽

Weight Maintenance ◽

Initial Response ◽

Serum Levels ◽

Lifestyle Factors ◽

Model Assessment ◽

Positive Weight

Background/Aims: The aim of our study was to evaluate the influence of lifestyle factors and molecular biomarkers on the maintenance of the weight lost after a hypocaloric Mediterranean diet. Design: After 3 months on a diet, patients (n = 335) remained with no controlled diet during 3 years and they were revaluated. Results: Using linear regression, in the group of responders, we detected that a positive weight loss at 3 months, serum levels of leptin at 3 months, and each 30 min per week of physical activity were associated with weight loss maintenance. In the model with reduced weight (RW) as dependent variable, a positive weight loss at 3 months was associated with 2.4% RW (95% CI 1.31–8.11; p = 0.015), each unit of serum leptin levels at 3 months with –0.44% RW (95% CI –0.59 to –0.020; p = 0.007), each basal unit homeostasis model assessment for insulin resistance (HOMA-IR) level with –2.32% (95% CI –13.01 to –0.17; p = 0.040), and each 30 min per week of physical activity with 1.58% RW (95% CI 1.08–2.94; p = 0.020). Conclusion: Obese subjects who are on maintenance weight loss after a dietary intervention appear to have a better initial response during the 3 months intervention, more physical activity at 3 years, and lower basal HOMA-IR and leptin after weight loss than those who regain weight.

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Increasing Energy Flux to Maintain Diet-Induced Weight Loss

Nutrients ◽

10.3390/nu11102533 ◽

2019 ◽

Vol 11 (10) ◽

pp. 2533 ◽

Cited By ~ 2

Author(s):

Christopher L. Melby ◽

Hunter L. Paris ◽

R. Drew Sayer ◽

Christopher Bell ◽

James O. Hill

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Body Weight ◽

Energy Balance ◽

Energy Expenditure ◽

Energy Flux ◽

Weight Maintenance ◽

High Energy ◽

Daily Energy

Long-term maintenance of weight loss requires sustained energy balance at the reduced body weight. This could be attained by coupling low total daily energy intake (TDEI) with low total daily energy expenditure (TDEE; low energy flux), or by pairing high TDEI with high TDEE (high energy flux). Within an environment characterized by high energy dense food and a lack of need for movement, it may be particularly difficult for weight-reduced individuals to maintain energy balance in a low flux state. Most of these individuals will increase body mass due to an inability to sustain the necessary level of food restriction. This increase in TDEI may lead to the re-establishment of high energy flux at or near the original body weight. We propose that following weight loss, increasing physical activity can effectively re-establish a state of high energy flux without significant weight regain. Although the effect of extremely high levels of physical activity on TDEE may be constrained by compensatory reductions in non-activity energy expenditure, moderate increases following weight loss may elevate energy flux and encourage physiological adaptations favorable to weight loss maintenance, including better appetite regulation. It may be time to recognize that few individuals are able to re-establish energy balance at a lower body weight without permanent increases in physical activity. Accordingly, there is an urgent need for more research to better understand the role of energy flux in long-term weight maintenance.

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Physical activity goals among patients in a primary care setting

Translational Behavioral Medicine ◽

10.1093/tbm/ibz061 ◽

2019 ◽

Vol 10 (3) ◽

pp. 792-800

Author(s):

Tonya Dodge ◽

Deepti Joshi ◽

Saud Abaalkhail ◽

Brad Moore

Keyword(s):

Physical Activity ◽

Primary Care ◽

Weight Loss ◽

Racial Differences ◽

Stress Reduction ◽

Care Setting ◽

Primary Care Setting ◽

Weight Maintenance ◽

Primary Care Patients ◽

Maintenance Goals

Abstract One approach to increasing physical activity (PA) among adults is to develop interventions targeting PA goals that could be implemented in the primary care setting. However, there is little understanding of the types of goals that individuals bring with them into the primary care setting, which is a necessary first step in building interventions. There were three objectives of the study. One was to identify the types of PA goals held by primary care patients. Another was to examine whether there were racial differences among types of PA goals held by primary care patients. A final objective was to examine the relationship between PA goals and PA behaviors (e.g., meet PA guidelines, number of breaks taken from PA routine). Adults (N = 626; Mage = 51.47, SD = 16.32) were recruited from the waiting room of a primary care clinic over a 30-day span to complete a questionnaire on PA and goals. The most commonly endorsed PA goals included, weight maintenance, overall health benefits, weight loss, well-being, body tone and/or shape, stress reduction, cardiovascular health, and energy level. Black patients were more likely than White patients to report weight loss and weight maintenance goals. Weight maintenance, overall health, and stress reduction are the goals for which the greatest percentage of individuals reported meeting aerobic PA guidelines. Finally, number of breaks taken and average length of breaks were similar across type of PA goal. A relatively small number of goals reflected a majority of the goals pursued by participants in this study. Racial differences in adoption of weight loss and weight maintenance goals highlight the need for further investigation into such differences. Finally, future research should consider the role that goal setting plays in PA adherence, paying particular attention to disparate levels of PA across racial groups.

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