title: Does the method of weight loss effect long-term changes in weight, body composition or chronic disease risk factors in overweight or obese adults? A systematic review.
abstract: BACKGROUND
  Differences in biological changes from weight loss by energy restriction and/or exercise may be associated with differences in long-term weight loss/regain.
  
  
  OBJECTIVE
  To assess the effect of weight loss method on long-term changes in weight, body composition and chronic disease risk factors.
  
  
  METHODS
  PubMed and Embase were searched (January 1990-October 2013) for studies with data on the effect of energy restriction, exercise (aerobic and resistance) on long-term weight loss. Twenty articles were included in this review.
  
  
  METHODS
  Primary source, peer reviewed randomized trials published in English with an active weight loss period of >6 months, or active weight loss with a follow-up period of any duration, conducted in overweight or obese adults were included.
  
  
  METHODS
  Considerable heterogeneity across trials existed for important study parameters, therefore a meta-analysis was considered inappropriate. Results were synthesized and grouped by comparisons (e.g. diet vs. aerobic exercise, diet vs. diet + aerobic exercise etc.) and study design (long-term or weight loss/follow-up).
  
  
  RESULTS
  Forty percent of trials reported significantly greater long-term weight loss with diet compared with aerobic exercise, while results for differences in weight regain were inconclusive. Diet+aerobic exercise resulted in significantly greater weight loss than diet alone in 50% of trials. However, weight regain (∼ 55% of loss) was similar in diet and diet+aerobic exercise groups. Fat-free mass tended to be preserved when interventions included exercise.
authors.affiliation: Cardiovascular Research Institute, Department of Internal Medicine, The University of Kansas Medical Center, Kansas City, Kansas, United States of America.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Washburn
authors.affiliation: Cardiovascular Research Institute, Department of Internal Medicine, The University of Kansas Medical Center, Kansas City, Kansas, United States of America.
authors.forename: Amanda N
authors.initials: AN
authors.lastname: Szabo
authors.affiliation: Cardiovascular Research Institute, Department of Internal Medicine, The University of Kansas Medical Center, Kansas City, Kansas, United States of America.
authors.forename: Kate
authors.initials: K
authors.lastname: Lambourne
authors.affiliation: Cardiovascular Research Institute, Department of Internal Medicine, The University of Kansas Medical Center, Kansas City, Kansas, United States of America.
authors.forename: Erik A
authors.initials: EA
authors.lastname: Willis
authors.affiliation: Cardiovascular Research Institute, Department of Internal Medicine, The University of Kansas Medical Center, Kansas City, Kansas, United States of America.
authors.forename: Lauren T
authors.initials: LT
authors.lastname: Ptomey
authors.affiliation: Cardiovascular Research Institute, Department of Internal Medicine, The University of Kansas Medical Center, Kansas City, Kansas, United States of America.
authors.forename: Jeffery J
authors.initials: JJ
authors.lastname: Honas
authors.affiliation: Sanford Research, Department of Children's Health Research Center, Sioux Falls, South Dakota, United States of America.
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Herrmann
authors.affiliation: Cardiovascular Research Institute, Department of Internal Medicine, The University of Kansas Medical Center, Kansas City, Kansas, United States of America.
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Donnelly
mesh_terms: D001823:Body Composition; D001835:Body Weight; D002908:Chronic Disease; D004038:Diet, Reducing; D015444:Exercise; D006801:Humans; D009765:Obesity / Q000628:therapy*; D050177:Overweight / Q000628:therapy*; D012307:Risk Factors; D015431:Weight Loss