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Effective Weight Loss and Maintenance by Intensive Start with Diet and Exercise

KAIKKONEN, KAISU M.1,2,3; SALTEVO, SAANA S.1,4; KORPELAINEN, JUHA T.4; VANHALA, MARJA L.1; JOKELAINEN, JARI J.2; KORPELAINEN, RAIJA I.1,2,3,4; KEINÄNEN-KIUKAANNIEMI, SIRKKA M.2,3,4

Medicine & Science in Sports & Exercise: May 2019 - Volume 51 - Issue 5 - p 920–929
doi: 10.1249/MSS.0000000000001855
APPLIED SCIENCES
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Introduction This 24-month study aimed to determine whether exercise intervention added to weight loss treatment at 6 months is effective for weight loss and maintenance.

Methods A total of 120 obese subjects (body mass index > 30) were randomly assigned to intensified behavioral modification (iBM) (n = 30), behavioral modification + exercise from 0 to 3 months (circuit weight training group 1 [CWT1]) (n = 30), behavioral modification + exercise from 6 to 9 months (CWT2) (n = 30), and a control group (CON) (n = 30). Health behavior, weight, waist circumference, and 2-h glucose tolerance test with insulin measurements were measured at 0, 3, 9, and 24 months.

Results Eighty-five subjects (mean age = 46 yr, body mass index = 36.3, 75.3% women) completed the trial. A significant weight loss occurred in CWT1 (−8.5 kg, P > 0.001), iBM (−5.5 kg, P > 0.001), and CWT2 (−4.4 kg, P = 0.007). CWT1 showed the highest reduction in waist circumference at 9 months (mean difference = −11.5 cm, P < 0.001) and 24 months (mean difference = −8.8 cm, P < 0.001). Both fasting and 2-h insulin values improved in the intervention groups compared with CON. A significant decrease in 2-h insulin values from baseline was found in CWT1 and CWT2. Matsuda index improved in the CWT1 group from the baseline to 24 months (2.03, P = 0.025).

Conclusion The most effective weight loss regimen is a combination of iBM and weight training introduced from the very beginning of the weight loss period. Treatment of morbid obesity should include an intensive start with exercise and diet regardless of weight status.

1Department of Sports and Exercise Medicine, Oulu Deaconess Institute, Oulu, FINLAND;

2Center for Life Course Health Research, University of Oulu, Oulu, FINLAND;

3Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, FINLAND; and

4Unit of Primary Health Care, Oulu University Hospital, Oulu, FINLAND

Address for correspondence: Kaisu Kaikkonen, M.Sc., Department of Sports and Exercise Medicine, Oulu Deaconess Institute, Albertinkatu 18 A, 90100 Oulu, Finland; E-mail: kaisu.kaikkonen@odl.fi.

Submitted for publication June 2018.

Accepted for publication November 2018.

© 2019 American College of Sports Medicine