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Long-term effectiveness of diet-plus-exercise interventions vs. diet-only interventions for weight loss: a meta-analysis
Open accessAbstract
Summary: Diet and exercise are two of the commonest strategies to reduce weight. Whether a diet‐plus‐exercise intervention is more effective for weight loss than a diet‐only intervention in the long‐term has not been conclusively established. The objective of this study was to systemically review the effect of diet‐plus‐exercise interventions vs. diet‐only interventions on both long‐term and short‐term weight loss. Studies were retrieved by searching MEDLINE and Cochrane Library (1966 – June 2008). Studies were included if they were randomized controlled trials comparing the effect of diet‐plus‐exercise interventions vs. diet‐only interventions on weight loss for a minimum of 6 months among obese or overweight adults. Eighteen studies met our inclusion criteria. Data were independently extracted by two investigators using a standardized protocol. We found that the overall standardized mean differences between diet‐plus‐exercise interventions and diet‐only interventions at the end of follow‐up were −0.25 (95% confidence interval [CI]−0.36 to −0.14), with a P‐value for heterogeneity of 0.4. Because there were two outcome measurements, weight (kg) and body mass index (kg m−2), we also stratified the results by weight and body mass index outcome. The pooled weight loss was 1.14 kg (95% CI 0.21 to 2.07) or 0.50 kg m−2 (95% CI 0.21 to 0.79) greater for the diet‐plus‐exercise group than the diet‐only group. We did not detect significant heterogeneity in either stratum. Even in studies lasting 2 years or longer, diet‐plus‐exercise interventions provided significantly greater weight loss than diet‐only interventions. In summary, a combined diet‐plus‐exercise programme provided greater long‐term weight loss than a diet‐only programme. However, both diet‐only and diet‐plus‐exercise programmes are associated with partial weight regain, and future studies should explore better strategies to limit weight regain and achieve greater long‐term weight loss.
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“Obesity interventions typically result in early rapid weight loss followed by a weight plateau and progressive regain.”
From Maintenance of Lost Weight and Long-Term Management of Obesity (2018) · cites this paper as [3]
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“concluding that participation in an exercise training program does favor weight loss, although of only modest magnitude.”
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 [28]
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“Weight loss can be achieved through a variety of modalities, but long-term maintenance of lost weight is much more challenging.”
From Maintenance of Lost Weight and Long-Term Management of Obesity (2018) · cites this paper as [3]
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Metadata
- Authors
- Wu, T., Gao, X., Chen, M., & Van Dam, R. M.
- Affiliations
- Harvard University (US)
- Corresponding author
- Wu, T.
- Venue
- Obesity Reviews
- Publisher
- Wiley
- Published
- 2009-04-24
- Volume
- 10
- Issue
- 3
- Pages
- 313-323
- ISSN
- 1467-7881 (ISSN-L)
- 1467-789X
- OpenAlex
- W2160779142
- Semantic Scholar
- 2e2c800320db9017115a2ee36508002f2df52542
- Cited by
- 515
- References
- 40
- Citations by year
- 2026: 8 · 2025: 29 · 2024: 24 · 2023: 23 · 2022: 26 · 2021: 31 · 2020: 42 · 2019: 35 · 2018: 40 · 2017: 47 · 2016: 35 · 2015: 37 · 2014: 33 · 2013: 37 · 2012: 25
- FWCI
- 3.03
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Obesity Reviews (publishedVersion)
- PubMed (publishedVersion)
- 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 › Pharmacology (medical) › Pharmacology and Obesity Treatment
- Keywords
- weight loss, obesity, overweight adults, long-term weight loss, body mass index, weight regain, combined diet and exercise
- MeSH terms
- Diet, Humans, Time Factors, Weight Loss, Exercise, Randomized Controlled Trials as Topic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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