title: Long-term weight losses associated with prescription of higher physical activity goals. Are higher levels of physical activity protective against weight regain?
abstract: BACKGROUND
  High levels of exercise may be necessary for long-term maintenance of weight loss.
  
  
  OBJECTIVE
  We aimed to determine in a randomized prospective design whether encouraging 2500 kcal physical activity/wk produced greater 30-mo weight losses than did the standard 1000 kcal physical activity/wk prescription.
  
  
  METHODS
  Overweight adults (n = 202) were randomly assigned to either 18 mo of standard behavioral treatment (SBT) with an exercise goal of 1000 kcal/wk or a high physical activity (HPA) treatment with a goal of 2500 kcal/wk. The HPA treatment included all procedures in the SBT plus encouragement to recruit 1-3 exercise partners and small-group counseling with an exercise coach. Participants were followed for 30 mo.
  
  
  RESULTS
  The HPA group achieved significantly greater exercise levels and weight losses than did the SBT group at 12 and 18 mo (P < 0.01). Weight losses did not differ significantly at 30 mo: 0.90 +/- 8.9 and 2.86 +/- 8.6 kg for the SBT and HPA groups, respectively (P = 0.16). At 30 mo, average exercise levels no longer differed significantly between groups (1390 and 1696 kcal/wk, respectively; P > 0.10). Participants sustaining high exercise levels (>2500 kcal/wk) for 30 mo had significantly (P < 0.001) greater 30-mo weight loss than did those exercising less (12 +/- 8.8 and 0.8 +/- 8.1 kg, respectively).
  
  
  CONCLUSIONS
  Although participants in the HPA group sustained the 2500-kcal activity goal during the 18-mo treatment, activity declined once treatment ended, which resulted in no between-group differences in activity or weight loss at 2.5 y. Participants who reported continuing to engage in high levels of exercise maintained a significantly larger weight loss.
authors.affiliation: Department of Health Behavior-Health Education and Nutrition, School of Public Health, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Deborah F
authors.initials: DF
authors.lastname: Tate
authors.forename: Robert W
authors.initials: RW
authors.lastname: Jeffery
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Sherwood
authors.forename: Rena R
authors.initials: RR
authors.lastname: Wing
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D004038:Diet, Reducing; D002149:Energy Intake / Q000502:physiology; D004734:Energy Metabolism / Q000502:physiology*; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss