A Randomized Trial Evaluating Exercise for the Prevention of Weight Regain
Open accessAbstract
Objective: This study aimed to evaluate the effectiveness of three levels of exercise on weight regain subsequent to clinically meaningful weight loss (WL). Methods: Adults with overweight or obesity (n = 298) initiated a 3‐month behavioral WL intervention, which included reduced energy intake, increased exercise, and weekly behavioral counseling. Participants achieving ≥5% WL (n = 235) began a 12‐month behavioral WL maintenance intervention and were randomized to 150 min/wk (n = 76), 225 min/wk (n = 80), or 300 min/wk (n = 79) of partially supervised moderate‐to‐vigorous–intensity exercise. Results: Participants randomized to 150, 225, and 300 minutes of exercise completed 129 ± 30, 153 ± 49 and 179 ± 62 min/wk of exercise (supervised + unsupervised), respectively. Mean WL at 3 months (9.5 ± 3.1 kg) was similar across randomized groups (P = 0.68). Weight change across 12 months was 1.1 ± 6.5 kg, 3.2 ± 5.7 kg, and 2.8 ± 6.9 kg in the 150, 225, and 300 min/wk groups, respectively. Intent‐to‐treat analysis revealed no significant overall trend across the three treatment groups (P = 0.09), effects for group (P = 0.08), or sex (P = 0.21). Conclusions: This study found no evidence for an association between the volume of moderate‐to‐vigorous–intensity exercise and weight regain across 12 months following clinically relevant WL. Further, results suggest that exercise volumes lower than those currently recommended for WL maintenance, when completed in conjunction with a behavioral weight‐maintenance intervention, may minimize weight regain over 12 months.
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Poor adherence to exercise protocols has been cited as the main reason why RCTs fail to demonstrate an effect of exercise on weight maintenance.
“Poor adherence to exercise protocols has been cited as the main reason why RCTs fail to demonstrate an effect of exercise on weight maintenance.”
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 [47]
In Clinical Trials and Investigations (page unavailable), the paper says earlier randomized trials struggled to achieve adherence to prescribed exercise and calls long-term compliance a major challenge for weight-maintenance trials. It does not identify poor adherence as the main reason RCTs fail to demonstrate an effect of exercise on weight maintenance. (LLM, conf=0.85)
Experimental — accuracy not yet measuredIn the METPOWeR trial, 88% of participants across groups maintained a 5% weight loss at 12 months, and mean weight regain ranged from 1.1 kg in the low-volume exercise group to 2.8 kg in the high-volume exercise group.
“Overall, 88% of participants across groups maintained a 5% weight loss at 12 months, and the mean weight regain ranged from 1.1 kg in the low‐volume exercise group to 2.8 kg in the high‐volume exercise group.”
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 [47]
The “Weight, BMI, and waist circumference” section (page unavailable) reports 88% for participants who completed the trial, not all participants across groups. It confirms mean regain of 1.1 kg in the low-volume group and 2.8 kg in the high-volume group, but the intermediate-volume group regained 3.2 kg, so 2.8 kg was not the upper end of the range. (LLM, conf=0.91)
Experimental — accuracy not yet measuredThe METPOWeR trial showed no significant difference in weight regain across three different volumes of aerobic exercise (150, 225, and 300 min/week) over 12 months after a ≥5% weight loss.
“However, the recently published results of the METPOWeR trial that evaluated the effectiveness of three different volumes of aerobic exercise (i.e., 150, 225, and 300 min/week), in addition to a behavioral weight maintenance program, on the prevention of weight regain over 12 months after a ≥5% weight loss showed no significant difference in weight regain across exercise groups.”
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- Authors
- Washburn, R. A., Szabo‐Reed, A. N., Gorczyca, A. M., Sullivan, D. K., Honas, J. J., Mayo, M. S., Krebill, R., Goetz, J., Ptomey, L. T., Lee, J., & Donnelly, J. E.
- Affiliations
- University of Kansas Medical Center (US)
- Department of Biostatistics & Data Science University of Kansas Medical Center University of Kansas Kansas City Kansas USA
- Texas Tech University (US)
- Corresponding author
- Szabo‐Reed, Amanda N.
- ORCID
- Venue
- Obesity
- Publisher
- Wiley
- Published
- 2020-12-21
- Volume
- 29
- Issue
- 1
- Pages
- 62-70
- ISSN
- 1930-7381 (ISSN-L)
- 1930-739X
- PMC
- PMC9260853
- OpenAlex
- W3114177172
- Semantic Scholar
- 49d8ef9dabbac2535130096070babc871a2ab0a4
- Cited by
- 29
- References
- 42
- Citations by year
- 2026: 8 · 2025: 5 · 2024: 4 · 2023: 5 · 2022: 3 · 2021: 3 · 2020: 1
- FWCI
- 2.25
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Obesity (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R01HL11842)
- National Institute of Diabetes and Digestive and Kidney Diseases (F32DK103493)
- National Center for Advancing Translational Sciences (KL2TR002367)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Keywords
- weight regain, weight loss maintenance, exercise volume, moderate-to-vigorous intensity exercise, overweight, behavioral weight loss, supervised exercise, energy intake reduction, sex differences
- MeSH terms
- Adult, Humans, Obesity, Weight Gain, Weight Loss, Exercise, Overweight
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