Is regular exercise an effective strategy for weight loss maintenance?
Open accessAbstract
Weight regain after weight loss is one of the most significant challenges to successful obesity treatment. Regular exercise has long been touted as a strategy for weight loss maintenance, but the lack of clear evidence in clinical trials has caused some to question its effectiveness. In this review, we present the arguments both questioning and in support of exercise as an obesity therapeutic. Our purpose is to bring clarity to the literature, present a unified perspective, and identify the gaps in knowledge that need to be addressed in future studies. Critical questions remain including sex differences, individual variability and compensatory behaviors in response to exercise, exercise adherence, the role of energy flux and the molecular mechanisms mediating the beneficial effects of exercise after weight loss and during weight regain. Future research should focus on these critical questions to provide a more complete understanding of the potential benefits of exercise on weight loss maintenance.
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The isolated benefits of exercise to prevent weight regain after weight loss is understudied.
“However, the isolated benefits of exercise to prevent weight regain after weight loss is understudied. 20”
From Healthy Weight Loss Maintenance with Exercise, Liraglutide, or Both Combined (2021) · cites this paper as [20]
Section 2.1 (page unavailable) says randomized trials lack convincing evidence that exercise improves weight-loss maintenance, supporting uncertainty about its benefit. But it also discusses numerous trials and does not say that the isolated benefit of exercise, as distinct from other interventions, has been understudied. (LLM, conf=0.78)
Experimental — accuracy not yet measuredRecent reviews pointed out a lack of controlled trials needed to provide more robust evidence on relations between physical activity and weight maintenance.
“Finally, relations between physical activity and weight maintenance have been widely investigated although recent reviews pointed out a lack of controlled trials that would be needed to provide more robust evidence.12, 13”
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 [13]
Section 2.1 (page not provided) says randomized controlled trials are the gold standard and that clear evidence for exercise as a weight-loss maintenance strategy is lacking. But it describes numerous existing trials whose results mostly fail to show a benefit; it does not say that a shortage of controlled trials is the reason more robust evidence is needed. (LLM, conf=0.84)
Experimental — accuracy not yet measuredRetrospective analyses of RCTs consistently showed that individuals who engaged in greater amounts of exercise experienced less weight regain, with a dose-response relationship.
“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”
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.”
The physiological effects induced by exercise may counter central neuroendocrine adaptive responses that favor weight regain.
“The physiological effects induced by exercise may counter central neuroendocrine adaptive responses that favor weight regain [241,242].”
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- Authors
- Foright, R. M., Presby, D. M., Sherk, V. D., Kahn, D., Checkley, L. A., Giles, E. D., Bergouignan, A., Higgins, J. A., Jackman, M. R., Hill, J. O., & MacLean, P. S.
- Affiliations
- University of Colorado Anschutz (US)
- Texas A&M University (US)
- Centre National de la Recherche Scientifique (FR)
- Corresponding author
- MacLean, P.S.
- ORCID
- Venue
- Physiology & Behavior
- Publisher
- Elsevier BV
- Published
- 2018-05
- Volume
- 188
- Pages
- 86-93
- ISSN
- 0031-9384 (ISSN-L)
- PMC
- PMC5929468
- OpenAlex
- W2791080987
- Cited by
- 113
- References
- 71
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 11 · 2023: 9 · 2022: 19 · 2021: 21 · 2020: 20 · 2019: 12 · 2018: 9
- FWCI
- 2.81
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Physiology & Behavior (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- HAL (submittedVersion)
- Funders
- National Institutes of Health (TL1TR001081, TL1TR002533, UL1TR001082)
- National Cancer Institute (K99CA169430, R01CA164166, R00CA169430)
- National Institute of Diabetes and Digestive and Kidney Diseases (F31DK115238, R00DK100465, K99DK100465, P30DK048520, T32DK007658)
- National Center for Advancing Translational Sciences
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (P50HD073063)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- physical activity, weight loss maintenance, weight regain, obesity treatment, compensatory behavior, exercise adherence, sex differences, energy balance, interindividual variability
- MeSH terms
- Humans, Sex Characteristics, Weight Loss, Exercise, Overweight
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