title: A physical activity program to reinforce weight maintenance following a behavior program in overweight/obese subjects.
abstract: OBJECTIVE
  To investigate the effects of a specific program to implement physical activity (fitness program) on weight loss maintenance, activity level and resting energy expenditure (REE).
  
  
  METHODS
  Observational study of subjects completing a behavioral program.
  
  
  METHODS
  In total, 200 overweight/obese subjects (36 males, aged 20-66 years; average BMI, 35.2 kg/m2). Program and measurements:The fitness program consisted of 12 bimonthly sessions, chaired by doctors and dietitians, involving groups of 8-12 subjects. Patients entered the program approximately 9 months after the end of behavioral treatment, during a weight loss maintenance period. The goal was set at a light-to-moderate daily physical activity (brisk walking), quantitatively measured by a pedometer; REE was measured before and after the fitness program by indirect calorimetry in a subset of patients.
  
  
  RESULTS
  The fitness program restarted the process of weight loss in over 60% of subjects. At the end of the study, 84% of patients walked at least 5000 steps per day, compared with 24% at the beginning of the study. The probability of losing from 5 to 10% of initial body weight increased by 20% for any 1000 steps/day (OR, 1.20; 95% CI (confidence interval), 1.07-1.35), and that of losing more than 10% by over 30% (OR, 1.33; 95% CI, 1.19-1.49). REE increased significantly by 100 kcal/day (+7.5%), in spite of further weight loss (-1.8%).
  
  
  CONCLUSIONS
  A specific fitness program in the weight maintenance phase after a behavioral program may significantly improve the long-term control of obesity.
authors.affiliation: Department Internal Medicine and Gastroenterology, Unit of Metabolic Diseases, Alma Mater Studiorum University of Bologna, Bologna, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Villanova
authors.forename: F
authors.initials: F
authors.lastname: Pasqui
authors.forename: S
authors.initials: S
authors.lastname: Burzacchini
authors.forename: G
authors.initials: G
authors.lastname: Forlani
authors.forename: R
authors.initials: R
authors.lastname: Manini
authors.forename: A
authors.initials: A
authors.lastname: Suppini
authors.forename: N
authors.initials: N
authors.lastname: Melchionda
authors.forename: G
authors.initials: G
authors.lastname: Marchesini
mesh_terms: D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy; D004734:Energy Metabolism; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000628:therapy*; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology / Q000628:therapy*; D015397:Program Evaluation; D016138:Walking; D015431:Weight Loss / Q000502:physiology