To Maintain Weight Loss, Exercise Even More

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To Maintain Weight Loss, Exercise Even More

Women who maintained a 10% weight loss during a 2-year study had better eating habits and more leisure-time physical activity than did those who regained weight lost during the first 6 months.

Experts generally recommend a minimum of 30 minutes of moderate-intensity activity on most days of the week (150 minutes weekly), but substantially more exercise probably is necessary to lose weight and to keep it off. Investigators randomized 191 overweight and obese women who were attending a weight-loss clinic into four groups: high or moderate energy expenditure (2000 vs. 1000 kcal/week) in the form of vigorous- or moderate-intensity exercise. Participants also were instructed to maintain a prescribed, reduced-caloric intake; all received intensive weight-loss counseling, regular group visits, and periodic telephone contact. Previous data from this study showed that average 12-month weight losses of 10% and 8% from baseline were associated with high and moderate amounts of exercise, respectively (JW Womens Health Nov 18 2003).

At 24 months, each group had regained on average about half the weight lost during the first 6 months. However, the 47 women who maintained weight loss of $≥$ 10% had increased their leisure-time physical activity from baseline by a mean of 1515 kcal weekly — substantially more than did women whose weight returned to or exceeded baseline (mean of 480 kcal weekly). No group maintained all of the eating behavior improvements seen at 6 months; however, at 24 months, women who kept their weight at least 10% below baseline retained more of the recommended eating behaviors than did other participants.

Comment: Once again, a study illustrates the difficulty of losing weight and keeping it off — even among highly motivated women enrolled in a weight-loss clinic and given significant support and resources (each participant received a treadmill). As backsliding occurred, the women regained weight. Those who sustained 10% weight losses during 2 years engaged in a level of physical activity that was approximately twice the typical public health recommendation. Considering the difficulty that overweight adults have in maintaining substantial weight loss, healthcare providers should continue to take a proactive stance toward minimizing weight gain in children and young adults, while also promoting more physical activity for all.

— Wendy S. Biggs, MD

Published in Journal Watch Women's Health September 4, 2008