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Effect of Exercise on 24-Month Weight Loss Maintenance in Overweight Women
Open accessAbstract
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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In the citing paper
“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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“In addition, exercise may preserve lean mass during weight loss(26) and thereby counteract the associated decrease in resting metabolic rate(27) which may explain the observation that individuals performing regular exercise have less body weight regain after weight loss compared with participants that do not exercise.…”
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“Postintervention, physical activity levels decrease over time (4,8,9).”
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Jakicic, J. M. (2012) · Nestlé Nutrition Institute Workshop series · doi:10.1159/000341283 · Cited by 20
Self-citationPhysical Activity in Obese Type 2 Diabetes After Gastric Bypass or Medical Management
Panosian, J., Ding, S.-A., Wewalka, M., Simonson, D. C., GOEBEL-FABBRI, A. E., Foster, K., Halperin, F., Vernon, A. H., & Goldfine, A. B. (2016) · The American Journal of Medicine · doi:10.1016/j.amjmed.2016.07.019 · Cited by 20
The effect of 4:3 intermittent fasting on weight loss at 12 months: a randomized clinical trial
Catenacci, V. A., Ostendorf, D. M., Pan, Z., Kaizer, L. K., Creasy, S. A., Zaman, A., Caldwell, A. E., Dahle, J., Swanson, B., Breit, M. J., et al. (2025) · Annals of Internal Medicine · doi:10.7326/annals-24-01631 · Cited by 20
Butryn, M. L., Kerrigan, S. G., Arigo, D., Raggio, G. A., & Forman, E. M. (2016) · Behavioral Medicine · doi:10.1080/08964289.2016.1170663 · Cited by 21
Effect of a Lifestyle Intervention on Cardiometabolic Health Among Emerging Adults
LaRose, J. G., Leahey, T. M., Lanoye, A. M., Bean, M. K., Fava, J. L., Tate, D. F., Evans, R. K., Wickham, E. P., & Henderson, M. M. (2022) · JAMA Network Open · doi:10.1001/jamanetworkopen.2022.31903 · Cited by 18
The usefulness of Integrative Neuromuscular Training to counteract obesity: a narrative review
Cavaggioni, L., Gilardini, L., Croci, M., Formenti, D., Merati, G., & Bertoli, S. (2023) · International Journal of Obesity · doi:10.1038/s41366-023-01392-4 · Cited by 25
Nakata, Y., OKADA, M., Hashimoto, K., Harada, Y., Sone, H., & Tanaka, K. (2014) · Obesity Facts · doi:10.1159/000369913 · Cited by 18
Sorkin, D. H., Biegler, K. A., & Billimek, J. (2015) · Journal of the American Geriatrics Society · doi:10.1111/jgs.13655 · Cited by 18
“Although physical activity is only one component of successful weight loss,(28) it has been documented to be an important factor in long-term weight maintenance.(29) The majority of studies examining the connection between physical activity and weight loss and maintenance were intervention trials that included moderat…”
BackgroundLe, S., Mao, L., Lu, D., Yang, Y., Tan, X. W., Wiklund, P., & Cheng, S. (2016) · Journal of sport and health science/Journal of Sport and Health Science · doi:10.1016/j.jshs.2016.04.003 · Cited by 17
Huang, Q., Wang, J., Wang, J., Yu, D., Zhan, Y., & Liu, Z. (2023) · Environmental Science & Technology · doi:10.1021/acs.est.3c03278 · Cited by 17
Nutrition Interventions for Obesity
Ard, J. D., Miller, G., & Kahan, S. I. (2016) · Medical Clinics of North America · doi:10.1016/j.mcna.2016.06.012 · Cited by 18
“The level of calories burned during physical activity is related to weight loss at long-term (18– 36 months) follow-up.(70,71) Women who achieved at least a 10% weight loss after 24 months of behavioral weight loss therapy reported activity energy expenditure of 1515 kcals/wk, compared with fewer than 500 kcals/wk in…”
BackgroundWhite, C. J., Drummond, S., & de Looy, A. (2010) · International Journal of Food Sciences and Nutrition · doi:10.3109/09637480903397355 · Cited by 17
“Additional interventions—such as the inclusion of increased physical activity—perhaps would have produced even more beneficial results (Kirkwood et al. 2007; Jakicic and Marcus 2008).”
BackgroundPsychological Treatments for Obesity in Youth and Adults
Presti, R. L., Lai, J., Hildebrandt, T., & Loeb, K. L. (2010) · Mount Sinai Journal of Medicine A Journal of Translational and Personalized Medicine · doi:10.1002/msj.20205 · Cited by 17
Effects of age, sex, and treatment on weight-loss dynamics in overweight people
Rojo-Tirado, M. A., Benito, P. J., Atienza, D., Rincón, E., & Calderón, F. J. (2013) · Applied Physiology, Nutrition, and Metabolism · doi:10.1139/apnm-2012-0441 · Cited by 16
“In those cases, BW was reduced by approximately 10% (Crncevć-Orlić et al. 2008; Jakicic et al. 2008; Larson-Meyer et al. 2010; Redman et al. 2007, 2009).”
BackgroundMethodResultInfluentialAnnesi, J. J. (2020) · Research Quarterly for Exercise and Sport · doi:10.1080/02701367.2020.1799917 · Cited by 17
Pallister, C., Avery, A., Stubbs, R. J., & Lavin, J. (2009) · Journal of Human Nutrition and Dietetics · doi:10.1111/j.1365-277x.2009.00959.x · Cited by 16
Time-Based Physical Activity Interventions for Weight Loss
Jakicic, J. M., Rickman, A. D., Lang, W., Davis, K. K., Gibbs, B. B., Neiberg, R. H., & Marcus, M. D. (2014) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000000482 · Cited by 16
Self-citationBrandão, A. D., da Silva, J. H. S., Lima, S. M. O., Lima, L., Loize, B., de Castro, A. A. M., Kümpel, C., & Pôrto, E. F. (2020) · Diabetology & Metabolic Syndrome · doi:10.1186/s13098-020-0522-y · Cited by 16
Olsén, M. F., Wiklund, M., Sandberg, E., Lundqvist, S., & Dean, E. (2021) · Physiotherapy Theory and Practice · doi:10.1080/09593985.2021.1885087 · Cited by 17
Tomaç, H., Malkoç, M., & Angın, E. (2023) · Heliyon · doi:10.1016/j.heliyon.2023.e19032 · Cited by 15
“In the literature, there are several studies about the positive effects of personalized exercise programs following bariatric surgery [10].”
BackgroundInfluentialThe Impact of Timing of Exercise Initiation on Weight Loss: An 18‐Month Randomized Clinical Trial
Catenacci, V. A., Ostendorf, D. M., Pan, Z., Bing, K., Wayland, L. T., Seyoum, E. A., Stauffer, B. L., Phelan, S., Creasy, S. A., Caldwell, A. E., et al. (2019) · Obesity · doi:10.1002/oby.22624 · Cited by 15
“Statistical analysis This study was powered to detect differences in weight loss at 18 months between the SEQ and the STD groups, and this was conservatively estimated based on data involving simultaneous delivery of diet and exercise interventions over 12 to 24 months (10,34).”
BackgroundMethodDo Overweight and Obese Individuals Select a “Moderate Intensity” Workload When Asked to Do So?
Hall, C., Holmstrup, M. E., Koloseus, J., Anderson, D., & Kanaley, J. A. (2012) · Journal of Obesity · doi:10.1155/2012/919051 · Cited by 16
Napolitano, M. A., & Hayes, S. (2010) · Journal of Obesity · doi:10.1155/2011/515803 · Cited by 15
“Although a minimum of 150 minutes per week of moderate intensity activity is suggested to reduce health risks [9], some researchers have reported that more activity may be necessary to prevent weight gain [7] and promote weight loss or prevent weight regain after a significant loss [10–12].”
BackgroundPope, L., Harvey‐Berino, J., Savage, P. D., Bunn, J. Y., Ludlow, M., Oldridge, N., & Ades, P. (2011) · Journal of Aging and Physical Activity · doi:10.1123/japa.19.2.99 · Cited by 15
Body Composition Changes after a Weight Loss Intervention: A 3-Year Follow-Up Study
Rojo‐Tirado, M. Á., Benito, P. J., Ruiz, J. R., Ortega, F. B., Romero‐Moraleda, B., Butragueño, J., Bermejo, L. M., de Castro, E. A., & Gómez‐Candela, C. (2021) · Nutrients · doi:10.3390/nu13010164 · Cited by 113
“Thus, the inability to sustain weight loss appears to mirror the inability to sustain physical activity [31].”
BackgroundPhysical Activity, Weight Loss, and Weight Maintenance in the DiOGenes Multicenter Trial
van Baak, M. A., Hul, G. B. J., Astrup, A. V., & Saris, W. H. M. (2021) · Frontiers in Nutrition · doi:10.3389/fnut.2021.683369 · Cited by 15
“Combined diet and exercise interventions on the long-term have been found to result in more weight loss than diet alone (8, 9).”
BackgroundOstendorf, D. M., Schmiege, S. J., Conroy, D. E., Phelan, S., Bryan, A. D., & Catenacci, V. A. (2021) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-021-01225-5 · Cited by 22
“However, behavioral weight loss interventions have been relatively unsuccessful in producing sustained changes in physical activity (PA) in both clinical and research settings [4, 5] and limited data exist on factors that are associated with longterm adherence to PA [6].”
BackgroundMacronutrient Content of the Diet: What Do We Know About Energy Balance and Weight Maintenance?
Fleming, J. A., & Kris‐Etherton, P. M. (2016) · Current Obesity Reports · doi:10.1007/s13679-016-0209-8 · Cited by 14
Role of physical activity in regulating appetite and body fat
Stensel, D. J., King, J. A., & Thackray, A. E. (2016) · Nutrition Bulletin · doi:10.1111/nbu.12234 · Cited by 15
“Follow-up of these same individuals at 24 months revealed that those who maintained high levels of physical activity (an average of 1835 kcal/week; 275 min/week) together with dietary restriction were able to sustain a weight loss of more than 10% (Jakicic et al. 2008).”
BackgroundRachakonda, V. P., DeLany, J. P., Kershaw, E. E., & Behari, J. (2019) · Hepatology Communications · doi:10.1002/hep4.1414 · Cited by 14
“(9) Dietary therapy included scheduled meetings with a prescribed diet shown to achieve sustained 8%-10% weight loss(12) and portions of the diet were provided in liquid supplements.”
MethodStrategies for Physical Activity Interventions in the Treatment of Obesity
Jakicic, J. M., Rogers, R. J., Collins, A. M., & Jackson, R. E. (2020) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2020.02.004 · Cited by 14
Self-citationSwift, D. L., Ross, L. M., Laddu, D. R., Conroy, M. B., German, C. A., Evangelista, L. S., Marvel, F. A., Jerome, G. J., on behalf the American Heart Association Council on Lifestyle and Cardiometabolic Health, Council on Cardiovascular and Stroke Nursing, et al. (2026) · Circulation · doi:10.1161/cir.0000000000001441 · Cited by 13
Blundell, J. E., & Beaulieu, K. (2023) · Appetite · doi:10.1016/j.appet.2023.106482 · Cited by 15
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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