Initial Weight Change and Long-Term Changes in Weight and Compensation during Supervised Exercise Training

Abstract

Introduction: Our primary aim was to investigate the association between initial weight change and longer-term changes in weight and compensation (predicted weight loss-observed weight loss) during exercise. As secondary aims, we investigated if initial weight change was related to change in cardiometabolic risk markers and energy balance modulators.

Methods: Two 6-month randomized controlled exercise trials conducted in individuals with overweight or obesity were analyzed (study 1, n = 312; study 2, n = 102). In both studies, participants in an exercise condition (4 kcal·kg-1·wk-1 [KKW], 8 KKW, 12 KKW, or 20 KKW) were split into tertiles based on percent weight change from baseline to week 4. Tertiles 1 and 3 exhibited the least and most initial weight loss, respectively. Changes in end points were compared between tertiles.

Results: At month 6, weight loss was lower in tertile 1 than tertile 3 (study 1: -3.6%, 95% confidence interval [CI] = -4.6 to -2.6; study 2: -1.8%, 95% CI = -3.1 to -0.4; P ≤ 0.034). Tertile 1 also showed greater compensation than tertile 3 in study 1 (3.0 kg, 95% CI = 2.2 to 3.9) and study 2 (1.5 kg, 95% CI = 0.3 to 2.6; P ≤ 0.048). Changes in triglycerides and, in study 1, HDL cholesterol were less favorable in tertile 1 versus tertile 3 (P ≤ 0.043); however, changes in other cardiometabolic markers were similar (P ≥ 0.209). In study 2, tertile 1 increased energy intake and exhibited maladaptive changes in eating behaviors relative to tertile 3 (P < 0.050). No between-tertile differences in cumulative exercise energy expenditure and physical activity were evident (P ≥ 0.321).

Conclusions: Less initial weight loss was associated with longer-term attenuated weight loss and greater compensation during aerobic exercise training. Individuals who display less initial weight loss during exercise may require early interventions to decrease compensation and facilitate weight loss.

Trial registration: ClinicalTrials.gov NCT01264406.

Copyright © 2021 by the American College of Sports Medicine.

Figures

Figure 1.

(A) Weight change data for participants in the DREW study with all weekly weight data up to week 24 (N = 110 [tertile 1: N = 34; tertile 2: N = 41; tertile 3: N = 35]). (B) Compensation data for participants in the DREW study with all weekly weight data up to week 24 (N = 110 [tertile 1: N = 34; tertile 2: N = 41; tertile 3: N = 35]). Data are from weekly weight measurements performed before exercise sessions. Participants in tertile 1 and tertile 3 had the least and most percent weight loss at week 4, respectively. Black arrows represent point where tertiles were calculated. Values are estimated marginal means (95% CI) adjusted for age, ethnicity, group and baseline.

Figure 2.

(A) Weight change data for participants in the E-MECHANIC study with all weekly weight data up to week 24 (N = 63 [tertile 1: N = 17; tertile 2: N = 21; tertile 3: N = 25]). (B) Compensation data for participants in the E-MECHANIC study with all weekly weight data up to week 24 (N = 63 [tertile 1: N = 17; tertile 2: N = 21; tertile 3: N = 25]). Data are from weekly weight measurements performed before exercise sessions. Participants in tertile 1 and tertile 3 had the least and most percent weight loss at week 4, respectively. Black arrows represent point where tertiles were calculated. Values are estimated marginal means (95% CI) adjusted for age, ethnicity, group, baseline, and sex.