Increased Physical Activity Associated with Less Weight Regain Six Years After "The Biggest Loser" Competition

Jennifer C Kerns, Juen Guo, Erin Fothergill, Lilian Howard, Nicolas D Knuth, Robert Brychta, Kong Y Chen, Monica C Skarulis, Peter J Walter, Kevin D Hall, Jennifer C Kerns, Juen Guo, Erin Fothergill, Lilian Howard, Nicolas D Knuth, Robert Brychta, Kong Y Chen, Monica C Skarulis, Peter J Walter, Kevin D Hall

Abstract

Objective: The aim of this study was to explore how physical activity (PA) and energy intake (EI) changes were related to weight loss and regain following "The Biggest Loser" competition.

Methods: At baseline, week 6 and week 30 of the competition, and 6 years after the competition, body composition was measured via dual-energy x-ray absorptiometry, resting energy expenditure was measured by using indirect calorimetry, and EI and PA were measured by using doubly labeled water.

Results: Six years after the competition, median weight loss in 14 of "The Biggest Loser" participants was 13%, with those maintaining a greater weight loss (mean ± SE) of 24.9% ± 3.8% having increased PA by 160% ± 23%, compared with a PA increase of 34% ± 25% (P = 0.0033) in the weight regainers who were 1.1% ± 4.0% heavier than the precompetition baseline. EI changes were similar between weight loss maintainers and regainers (-8.7% ± 5.6% vs. -7.4% ± 2.7%, respectively; P = 0.83). Weight regain was inversely associated with absolute changes in PA (r = -0.82; P = 0.0003) but not with changes in EI (r = -0.15; P = 0.61). EI and PA changes explained 93% of the individual weight loss variability at 6 years.

Conclusions: Consistent with previous reports, large and persistent increases in PA may be required for long-term maintenance of lost weight.

Trial registration: ClinicalTrials.gov NCT02544009.

Conflict of interest statement

Disclosure: No other authors have conflicting interests.

© 2017 The Obesity Society.

Figures

Figure 1
Figure 1
Six years after the Biggest Loser competition, the median percent weight loss compared to the pre-competition baseline was 13%. The increase in physical activity from baseline to six years was significantly higher in the seven weight loss maintainers (160 ± 23%) compared to the seven weight regainers (34 ± 25 %; p = 0.0033), while the percent change in energy intake did not significantly differ between weight loss maintainers and regainers (−8.7 ± 5.6% vs −7.4± 2.7 %, respectively; p=0.83).
Figure 2
Figure 2
Individual changes in absolute (A) energy intake, and (B) physical activity from pre-competition baseline to six years after the Biggest Loser competition were both significantly correlated with weight loss six years after the competition.
Figure 3
Figure 3
(A) Energy intake changes were not significantly correlated with weight regained in the six years after the Biggest Loser competition. (B) Physical activity changes were significantly inversely related to weight regained.
Figure 4
Figure 4
Neither the weight lost at six weeks (A), nor 30 weeks (B) was significantly associated with physical activity changes from the pre-competition baseline. Changes in energy intake were significantly correlated with weight loss after both six weeks (C) and 30 weeks (D).

References

    1. Loveman E, Frampton GK, Shepherd J, Picot J, Cooper K, Bryant J, et al. The clinical effectiveness and cost-effectiveness of long-term weight management schemes for adults: a systematic review. Health technology assessment (Winchester, England) 2011;15:1–182.
    1. Wing RR, Phelan S. Long-term weight loss maintenance. Am J Clin Nutr. 2005;82:222S–225S.
    1. Wu T, Gao X, Chen M, van Dam RM. Long-term effectiveness of diet-plus-exercise interventions vs. diet-only interventions for weight loss: a meta-analysis. Obes Rev. 2009;10:313–323.
    1. Fothergill E, Guo J, Howard L, Kerns JC, Knuth ND, Brychta R, et al. Persistent metabolic adaptation 6 years after "The Biggest Loser" competition. Obesity (Silver Spring) 2016;24:1612–1619.
    1. Johanssen DL, Knuth ND, Huizenga R, Rood J, Ravussin E, Hall KD. Metabolic slowing with massive weight loss despite preservation of fat-free mass. J Clin Endocrinol Metab. 2012;97:2489–2496.
    1. Knuth ND, Johannsen DL, Tamboli RA, Marks-Shulman PA, Huizenga R, Chen KY, et al. Metabolic adaptation following massive weight loss is related to the degree of energy imbalance and changes in circulating leptin. Obesity (Silver Spring) 2014;22:2563–2569.
    1. Barnes AS, Kimbro RT. Descriptive study of educated African American women successful at weight-loss maintenance through lifestyle changes. Journal of general internal medicine. 2012;27:1272–1279.
    1. Catenacci VA, Ogden LG, Stuht J, Phelan S, Wing RR, Hill JO, et al. Physical activity patterns in the National Weight Control Registry. Obesity (Silver Spring) 2008;16:153–161.
    1. Jakicic JM, Marcus BH, Lang W, Janney C. Effect of exercise on 24-month weight loss maintenance in overweight women. Archives of internal medicine. 2008;168:1550–1559. discussion 1559–1560.
    1. Jeffery RW, Wing RR, Sherwood NE, Tate DF. Physical activity and weight loss: does prescribing higher physical activity goals improve outcome? Am J Clin Nutr. 2003;78:684–689.
    1. Kayman S, Bruvold W, Stern JS. Maintenance and relapse after weight loss in women: behavioral aspects. Am J Clin Nutr. 1990;52:800–807.
    1. Klem ML, Wing RR, McGuire MT, Seagle HM, Hill JO. A descriptive study of individuals successful at long-term maintenance of substantial weight loss. Am J Clin Nutr. 1997;66:239–246.
    1. Kruger J, Blanck HM, Gillespie C. Dietary and physical activity behaviors among adults successful at weight loss maintenance. The international journal of behavioral nutrition and physical activity. 2006;3:17.
    1. Kruger J, Blanck HM, Gillespie C. Dietary practices, dining out behavior, and physical activity correlates of weight loss maintenance. Preventing chronic disease. 2008;5:A11.
    1. Look AHEAD Research Group. Eight-year weight losses with an intensive lifestyle intervention: the Look AHEAD study. Obesity (Silver Spring) 2014;22:5–13.
    1. Tate DF, Jeffery RW, Sherwood NE, Wing RR. Long-term weight losses associated with prescription of higher physical activity goals. Are higher levels of physical activity protective against weight regain? Am J Clin Nutr. 2007;85:954–959.
    1. Thomas JG, Bond DS, Phelan S, Hill JO, Wing RR. Weight-loss maintenance for 10 years in the National Weight Control Registry. American journal of preventive medicine. 2014;46:17–23.
    1. Calabro MA, Kim Y, Franke WD, Stewart JM, Welk GJ. Objective and subjective measurement of energy expenditure in older adults: a doubly labeled water study. Eur J Clin Nutr. 2015;69:850–855.
    1. Lichtman SW, Pisarska K, Berman ER, Pestone M, Dowling H, Offenbacher E, et al. Discrepancy between self-reported and actual caloric intake and exercise in obese subjects. N Engl J Med. 1992;327:1893–1898.
    1. Neilson HK, Robson PJ, Friedenreich CM, Csizmadi I. Estimating activity energy expenditure: how valid are physical activity questionnaires? Am J Clin Nutr. 2008;87:279–291.
    1. Racette SB, Schoeller DA, Kushner RF. Comparison of heart rate and physical activity recall with doubly labeled water in obese women. Med Sci Sports Exerc. 1995;27:126–133.
    1. Walsh MC, Hunter GR, Sirikul B, Gower BA. Comparison of self-reported with objectively assessed energy expenditure in black and white women before and after weight loss. Am J Clin Nutr. 2004;79:1013–1019.
    1. Bonnefoy M, Normand S, Pachiaudi C, Lacour JR, Laville M, Kostka T. Simultaneous validation of ten physical activity questionnaires in older men: a doubly labeled water study. Journal of the American Geriatrics Society. 2001;49:28–35.
    1. Catenacci VA, Grunwald GK, Ingebrigtsen JP, Jakicic JM, McDermott MD, Phelan S, et al. Physical activity patterns using accelerometry in the National Weight Control Registry. Obesity (Silver Spring) 2011;19:1163–1170.
    1. Phelan S, Roberts M, Lang W, Wing RR. Empirical evaluation of physical activity recommendations for weight control in women. Med Sci Sports Exerc. 2007;39:1832–1836.
    1. Jakicic JM, Tate DF, Lang W, Davis KK, Polzien K, Neiberg RH, et al. Objective physical activity and weight loss in adults: the step-up randomized clinical trial. Obesity (Silver Spring) 2014;22:2284–2292.
    1. Rothney MP, Brychta RJ, Schaefer EV, Chen KY, Skarulis MC. Body composition measured by dual-energy X-ray absorptiometry half-body scans in obese adults. Obesity (Silver Spring) 2009;17:1281–1286.
    1. Hall KD, Bemis T, Brychta R, Chen KY, Courville A, Crayner EJ, et al. Calorie for Calorie, Dietary Fat Restriction Results in More Body Fat Loss than Carbohydrate Restriction in People with Obesity. Cell Metab. 2015;22:427–436.
    1. Racette SB, Schoeller DA, Luke AH, Shay K, Hnilicka J, Kushner RF. Relative dilution spaces of 2H- and 18O-labeled water in humans. Am J Physiol. 1994;267:E585–590.
    1. Hall KD. Diet versus exercise in "the biggest loser" weight loss competition. Obesity (Silver Spring) 2013;21:957–959.
    1. Racette SB, Das SK, Bhapkar M, Hadley EC, Roberts SB, Ravussin E, et al. Approaches for quantifying energy intake and %calorie restriction during calorie restriction interventions in humans: the multicenter CALERIE study. Am J Physiol Endocrinol Metab. 2012;302:E441–448.
    1. Schoeller DA, Jefford G. Determinants of the energy costs of light activities: inferences for interpreting doubly labeled water data. Int J Obes (Lond) 2002;26:97–101.
    1. Del Corral P, Bryan DR, Garvey WT, Gower BA, Hunter GR. Dietary adherence during weight loss predicts weight regain. Obesity (Silver Spring) 2011;19:1177–1181.
    1. Schoeller DA, Shay K, Kushner RF. How much physical activity is needed to minimize weight gain in previously obese women? Am J Clin Nutr. 1997;66:551–556.
    1. de Jonge L, DeLany JP, Nguyen T, Howard J, Hadley EC, Redman LM, et al. Validation study of energy expenditure and intake during calorie restriction using doubly labeled water and changes in body composition. Am J Clin Nutr. 2007;85:73–79.

Source: PubMed

3
订阅