Exercise for overweight or obesity.
BACKGROUND
Clinical trials have shown that exercise in adults with overweight or obesity can reduce bodyweight. There has been no quantitative systematic review of this in The Cochrane Library.


OBJECTIVE
To assess exercise as a means of achieving weight loss in people with overweight or obesity, using randomised controlled clinical trials.


METHODS
Studies were obtained from computerised searches of multiple electronic bibliographic databases. The last search was conducted in January 2006.


METHODS
Studies were included if they were randomised controlled trials that examined body weight change using one or more physical activity intervention in adults with overweight or obesity at baseline and loss to follow-up of participants of less than 15%.


METHODS
Two authors independently assessed trial quality and extracted data.


RESULTS
The 43 studies included 3476 participants. Although significant heterogeneity in some of the main effects' analyses limited ability to pool effect sizes across some studies, a number of pooled effect sizes were calculated. When compared with no treatment, exercise resulted in small weight losses across studies. Exercise combined with diet resulted in a greater weight reduction than diet alone (WMD -1.1 kg; 95% confidence interval (CI) -1.5 to -0.6). Increasing exercise intensity increased the magnitude of weight loss (WMD -1.5 kg; 95% CI -2.3 to -0.7). There were significant differences in other outcome measures such as serum lipids, blood pressure and fasting plasma glucose. Exercise as a sole weight loss intervention resulted in significant reductions in diastolic blood pressure (WMD -2 mmHg; 95% CI -4 to -1), triglycerides (WMD -0.2 mmol/L; 95% CI -0.3 to -0.1) and fasting glucose (WMD -0.2 mmol/L; 95% CI -0.3 to -0.1). Higher intensity exercise resulted in greater reduction in fasting serum glucose than lower intensity exercise (WMD -0.3 mmol/L; 95% CI -0.5 to -0.2). No data were identified on adverse events, quality of life, morbidity, costs or on mortality.


CONCLUSIONS
The results of this review support the use of exercise as a weight loss intervention, particularly when combined with dietary change. Exercise is associated with improved cardiovascular disease risk factors even if no weight is lost.
Shaw
K
K
Department of Health and Human Services, Public and Environmental Health Unit, Public Health Unit, 152 Macquarie Street, Hobart, Tasmania, Australia. kelly.shaw@dhhs.tas.gov.au
Gennat
H
H
O'Rourke
P
P
Del Mar
C
C
D000328:Adult; D004038:Diet, Reducing; D015444:Exercise; D006801:Humans; D009765:Obesity / Q000628:therapy*; D050177:Overweight; D016032:Randomized Controlled Trials as Topic; D015431:Weight Loss