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Effect of Exercise on 24-Month Weight Loss Maintenance in Overweight Women
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BACKGROUND: Debate remains regarding the amount of physical activity that will facilitate weight loss maintenance. METHODS: Between December 1, 1999, and January 31, 2003, 201 overweight and obese women (body mass index [calculated as weight in kilograms divided by height in meters squared], 27 to 40; age range, 21-45 years) with no contraindications to weight loss or physical activity were recruited from a hospital-based weight loss research center. Participants were assigned to 1 of 4 behavioral weight loss intervention groups. They were randomly assigned to groups based on physical activity energy expenditure (1000 vs 2000 kcal/wk) and intensity (moderate vs vigorous). Participants also were told to reduce intake to 1200 to 1500 kcal/d. A combination of in-person conversations and telephone calls were conducted during the 24-month study period. RESULTS: Weight loss did not differ among the randomized groups at 6 months' (8%-10% of initial body weight) or 24 months' (5% of initial body weight) follow-up. Post-hoc analysis showed that individuals sustaining a loss of 10% or more of initial body weight at 24 months reported performing more physical activity (1835 kcal/wk or 275 min/wk) compared with those sustaining a weight loss of less than 10% of initial body weight (P < .001). CONCLUSIONS: The addition of 275 mins/wk of physical activity, in combination with a reduction in energy intake, is important in allowing overweight women to sustain a weight loss of more than 10%. Interventions to facilitate this level of physical activity are needed.
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“engaging in 275 min per week of physical activity is associated with more sustained weight maintenance after initial successful weight loss (26).”
From The Benefits of Exercise Training in Combination With Weight Loss Therapies (2025) · cites this paper as [26]
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“As recently summarized,13 this is in contrast with retrospective analyses of these RCTs that consistently showed that individuals who engaged in greater amounts of exercise experienced less weight regain, with a dose–response relationship”
From 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 (2021) · cites this paper as [44]
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“All participants also reported at baseline and years 1–4, as well as at year 8, the number of weeks in the prior year that they engaged in behaviors previously determined to be associated with long-term weight control: 1) increasing physical activity;27–29 2) monitoring body weight;30,31 3) reducing calorie and fat intake;32,33 and 4) using meal replacements.33”
From Eight-year weight losses with an intensive lifestyle intervention: The look AHEAD study (2014) · cites this paper as [29]
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“and that relatively large volumes of exercise (≥250 min/week) might be needed to prevent weight regain.”
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“On the average, the more exercise carried out, the greater the weight loss.”
From Appetite control and energy balance: Impact of exercise (2015) · cites this paper as [6]
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“The effect is clearly present whether the exercise is measured in minutes of activity per week or in kcal energy expended.”
From Appetite control and energy balance: Impact of exercise (2015) · cites this paper as [6]
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“There is clear evidence from large scale controlled trials that PA carried out over long periods of time produces a dose-dependent reduction in body weight [5, 6].”
From Appetite control and energy balance: Impact of exercise (2015) · cites this paper as [6]
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BackgroundA role for exercise after bariatric surgery?
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“In the context of diet-induced calorie restriction, maintaining weight loss is a well-recognized problem, with one report suggesting that 12–18 months after weight loss, 33–50% of initial weight loss is regained [42]; however, exercise has been shown to be beneficial for long-term weight loss maintenance after calorie…”
BackgroundRegular exercise attenuates the metabolic drive to regain weight after long-term weight loss
MacLean, P. S., HIGGINS, J. A., Wyatt, H. R., Melanson, E. L., Johnson, G. C., Jackman, M. R., Giles, E. D., Brown, I. E., & Hill, J. O. (2009) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00192.2009 · Cited by 78
“Regardless, studies in both animals and humans provide evidence that being more physically active results in less regain (16, 17, 21).”
BackgroundPo'e, E. K., Heerman, W. J., Mistry, R. S., & Barkin, S. L. (2013) · Contemporary Clinical Trials · doi:10.1016/j.cct.2013.08.013 · Cited by 78
“This tiered intervention approach is based on effective obesity intervention strategies [37–40].”
MethodKim, B., Choi, D., Jung, C., Kang, S., Mok, J., & Kim, C. (2017) · Journal of Obesity & Metabolic Syndrome · doi:10.7570/jomes.2017.26.1.15 · Cited by 83
The Effect of Physical Activity on 18‐Month Weight Change in Overweight Adults
Jakicic, J. M., Otto, A. D., Lang, W., Semler, L., Winters, C., Polzien, K. M., & Mohr, K. I. (2010) · Obesity · doi:10.1038/oby.2010.122 · Cited by 85
“Moreover, the progression of PA followed a reasonable clinical approach to minimize injury risk from overuse too early within the intervention, and is similar to a progression that we have used in a prior weight-loss study (8,9).”
BackgroundMethodResultInfluentialSelf-citationPhelan, S., Liu, T., Gorin, A. A., Lowe, M. R., Hogan, J. W., Fava, J. L., & Wing, R. R. (2009) · Annals of Behavioral Medicine · doi:10.1007/s12160-009-9135-2 · Cited by 79
Ostendorf, D. M., Caldwell, A. E., Creasy, S. A., Pan, Z., Lyden, K. A., Bergouignan, A., MacLean, P. S., Wyatt, H. R., Hill, J. O., Melanson, E. L., et al. (2019) · Obesity · doi:10.1002/oby.22373 · Cited by 82
“Much of the evidence demonstrating that successful WLM sustain high levels of PA is based on studies that have used self-reported measures (20-22) or activity monitors (16,17,19).”
BackgroundExploring Gender Differences in a Randomized Trial of Weight Loss Maintenance
Crane, M. M., Jeffery, R. W., & Sherwood, N. E. (2016) · American Journal of Men s Health · doi:10.1177/1557988316681221 · Cited by 82
Pearl, R. L., Wadden, T. A., Bach, C., Gruber, K. A., Leonard, S. M., Walsh, O. A., Tronieri, J. S., & Berkowitz, R. I. (2020) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000480 · Cited by 81
Prakash, K., & Munyanyi, M. E. (2021) · Energy Economics · doi:10.1016/j.eneco.2021.105428 · Cited by 75
An exploration of the experiences and perceptions of people who have maintained weight loss
Hindle, L., & Carpenter, C. (2011) · Journal of Human Nutrition and Dietetics · doi:10.1111/j.1365-277x.2011.01156.x · Cited by 72
“Kayman et al. (1990) found that maintainers and those who had never been overweight were more likely to seek support from friends, family and professionals to deal with problem situations in their life and were likely to use problem focused coping strategies.”
BackgroundResultInfluentialDose response of exercise training following roux‐en‐Y gastric bypass surgery: A randomized trial
Woodlief, T., Carnero, E. Á., Standley, R. A., Distéfano, G., Anthony, S. J., Dubis, G., Jakicic, J. M., Houmard, J. A., Coen, P. M., & Goodpaster, B. H. (2015) · Obesity · doi:10.1002/oby.21332 · Cited by 72
“Moreover, although the amount of weekly exercise has been associated with greater weight loss (10) and improvements in both insulin sensitivity (11) and b-cell function (12) among nonseverely obese subjects, the amount of exercise required to improve health outcomes in bariatric surgery patients is not clear.”
BackgroundSelf-citationExercise and bariatric surgery: an effective therapeutic strategy
Coen, P. M., Carnero, E. A., & Goodpaster, B. H. (2018) · Exercise and Sport Sciences Reviews · doi:10.1249/jes.0000000000000168 · Cited by 71
“Exercise has proven to be an important factor for long-term weight loss maintenance after calorie restriction (44).”
BackgroundCognitive and Behavioral Approaches in the Treatment of Obesity
Dorsten, B. V., & Lindley, E. M. (2011) · Medical Clinics of North America · doi:10.1016/j.mcna.2011.06.008 · Cited by 75
Follow-up after bariatric surgery: A review
Bjørklund, G., Semenova, Y. M., Pivina, L. M., & Costea, D. O. (2020) · Nutrition · doi:10.1016/j.nut.2020.110831 · Cited by 74
Achieving Hunter-gatherer Fitness in the 21st Century: Back to the Future
O'Keefe, J. H., Vogel, R., Lavie, C. J., & Cordain, L. (2010) · The American Journal of Medicine · doi:10.1016/j.amjmed.2010.04.026 · Cited by 67
Bellicha, A., Ciangura, C., Roda, C., Torcivia, A., Aron‐Wisnewsky, J., Poitou, C., & Oppert, J. (2022) · PLoS ONE · doi:10.1371/journal.pone.0271561 · Cited by 74
Catenacci, V. A., Odgen, L., Phelan, S., Thomas, J. G., Hill, J. O., Wing, R. R., & Wyatt, H. R. (2014) · Journal of Physical Activity and Health · doi:10.1123/jpah.2012-0250 · Cited by 70
Akers, J. D., Cornett, R. A., Savla, J. T., Davy, K. P., & Davy, B. M. (2012) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2012.01.022 · Cited by 66
Exercise and the metabolic syndrome with weight regain
Thomas, T. R., Warner, S. O., Dellsperger, K. C., Hinton, P. S., Whaley‐Connell, A. T., Rector, R. S., Liu, Y., Linden, M. A., Chockalingam, A., Thyfault, J. P., et al. (2010) · Journal of Applied Physiology · doi:10.1152/japplphysiol.01361.2009 · Cited by 65
“Recent data suggest that weight often is regained in a 85 short period of time (14, 26, 31, 32), and even chronic exercisers may gain weight over 86 time (34).”
BackgroundJakicic, J. M., Egan, C., Fabricatore, A. N., Gaussoin, S. A., Glasser, S. P., Hesson, L. A., Knowler, W. C., Lang, W., Regensteiner, J. G., Ribisl, P. M., et al. (2012) · Diabetes Care · doi:10.2337/dc12-0712 · Cited by 65
Self-citationBody–Brain Connections: The Effects of Obesity and Behavioral Interventions on Neurocognitive Aging
Stillman, C. M., Weinstein, A. M., Marsland, A. L., Gianaros, P. J., & Erickson, K. I. (2017) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2017.00115 · Cited by 69
“Instead, PA interventions more reliably change body composition (i.e., increase lean muscle mass and decrease adiposity), which can help prevent weight gain (Jakicic et al., 2008; Jakicic, 2009).”
BackgroundPrevalence and Predictors of Weight-Loss Maintenance in a Biracial Cohort
Phelan, S., Wing, R. R., Loria, C. M., Kim, Y., & Lewis, C. E. (2010) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2010.08.008 · Cited by 63
Objective physical activity and weight loss in adults: The step-up randomized clinical trial
Jakicic, J. M., Tate, D. F., Lang, W., Davis, K. K., Polzien, K. M., Neiberg, R. H., Rickman, A. D., & Erickson, K. (2014) · Obesity · doi:10.1002/oby.20830 · Cited by 61
Self-citationUnleashing Physical Activity: An Observational Study of Park Use, Dog Walking, and Physical Activity
Temple, V., Rhodes, R., & Higgins, J. W. (2011) · Journal of Physical Activity and Health · doi:10.1123/jpah.8.6.766 · Cited by 62
“Visits occurred over 2 observational time periods: (1) 6 weeks in May, June, and September 2007 (avoiding summer holidays), and (2) 6 weeks in January through April 2008.”
BackgroundShort‐term weight loss with diet and physical activity in young adults: The IDEA study
Jakicic, J. M., King, W. C., Marcus, M. D., Davis, K. K., Helsel, D. L., Rickman, A. D., Gibbs, B. B., Rogers, R. J., Wahed, A. S., & Belle, S. H. (2015) · Obesity · doi:10.1002/oby.21241 · Cited by 62
Self-citationObesity Reduction Black Intervention Trial (ORBIT): 18‐Month Results
Fitzgibbon, M., Stolley, M. R., Schiffer, L. A., Sharp, L. K., Singh, V., & Dyer, A. R. (2010) · Obesity · doi:10.1038/oby.2010.47 · Cited by 63
Longitudinal Assessment of Physical Activity in Women Undergoing Roux-en-Y Gastric Bypass
Berglind, D., Willmer, M., Eriksson, U., Thorell, A., Sundbom, M., Uddén, J., Raoof, M., Hedberg, J., Tynelius, P., Näslund, E. B., et al. (2014) · Obesity Surgery · doi:10.1007/s11695-014-1331-x · Cited by 61
“A substantial increase in PA is required to maintain a lower weight in previously obese adults [5] while the contribution of PA to weight result postbariatric surgery remains unclear with conflicting results from several studies [6, 7].”
ResultAdamo, K. B., Ferraro, Z. M., Goldfield, G. S., Keely, E., Stacey, D., Hadjiyannakis, S., Jean‐Philippe, S., WALKER, M. C., & Barrowman, N. J. (2013) · Contemporary Clinical Trials · doi:10.1016/j.cct.2013.02.010 · Cited by 62
“Energy expenditure is an important weight management strategy for all populations [61].”
BackgroundWhat is the most effective way to maintain weight loss in adults?
Simpson, S. A., Shaw, C., & McNamara, R. L. (2011) · BMJ · doi:10.1136/bmj.d8042 · Cited by 61
Beaulieu, K., Blundell, J. E., van Baak, M. A., Battista, F., Busetto, L., Carraça, E. V., Dicker, D., Encantado, J., Ermolao, A., Farpour‐Lambert, N. J., et al. (2021) · Obesity Reviews · doi:10.1111/obr.13251 · Cited by 66
“Evidence demonstrates that the degree of success of weight loss and weight loss maintenance in people living with obesity is related to the amount of physical activity performed measured by minutes spent or energy expended.(3,4) Short-term controlled trials with supervised regular exercise can show clear (but modest)…”
BackgroundWeight Reduction with GLP-1 Agonists and Paths for Discontinuation While Maintaining Weight Loss
Reiss, A. B., Gulkarov, S., Lau, R., Klek, S. P., Srivastava, A., Renna, H. A., & De Leon, J. (2025) · Biomolecules · doi:10.3390/biom15030408 · Cited by 58
“For instance, those with high levels of physical activity are more successful at weight loss maintenance [257–259].”
Simpson, S. A., McNamara, R. L., Shaw, C., Kelson, M. J., Moriarty, Y., Randell, E., Cohen, D. R., Alam, M. F., Copeland, L., Duncan, D., et al. (2015) · Health Technology Assessment · doi:10.3310/hta19500 · Cited by 64
“Secondary analyses of one well-designed trial found that individuals reporting higher levels of physical activity (275 minutes per week) were better able to maintain 10% weight loss at 24 months.(32) Another review identified that 60–90 minutes of moderate-intensity activity per day is needed to prevent weight regain.”
Background
Metadata
- Authors
- Jakicic, J. M.
- Affiliations
- University of Pittsburgh (US)
- Corresponding author
- Jakicic, John M.
- ORCID
- Jakicic, John M.
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2008-07-28
- Volume
- 168
- Issue
- 14
- Pages
- 1550
- ISSN
- 0003-9926 (ISSN-L)
- PMC
- PMC2829743
- OpenAlex
- W2141214903
- Cited by
- 370
- References
- 33
- Citations by year
- 2026: 15 · 2025: 13 · 2024: 10 · 2023: 15 · 2022: 10 · 2021: 28 · 2020: 16 · 2019: 16 · 2018: 16 · 2017: 21 · 2016: 24 · 2015: 24 · 2014: 22 · 2013: 23 · 2012: 19
- FWCI
- 32.12
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (HL 64991, R01HL064991)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health and Lifestyle Studies
- Keywords
- weight loss maintenance, physical activity, overweight women, obesity, energy expenditure, exercise intensity, caloric restriction, behavioral weight loss, telephone counseling, weight loss sustainability
- MeSH terms
- Adult, Energy Intake, Exercise Therapy, Female, Follow-Up Studies, Humans, Middle Aged, Surveys and Questionnaires, Retrospective Studies, Time Factors, Weight Loss, Treatment Outcome, Overweight
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