Initial weight change and long-term changes in weight and compensation during supervised exercise training

Dorling, J. , Hochsman, C., Fearnbach, S. N., Apolzan, J. W., Hsia, D. S., Johannsen, N. M., Church, T. S. and Martin, C. K. (2021) Initial weight change and long-term changes in weight and compensation during supervised exercise training. Medicine and Science in Sports and Exercise, 53(8), pp. 1675-1684. (doi: 10.1249/MSS.0000000000002633)

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.

• Item Type: Articles
• Additional Information: This work was supported by the National Institutes of Health (grant nos. HL66262 and HL102166), the NORC (grant no. P30 DK072476, titled “Nutritional Programming: Environmental and Molecular Interactions” sponsored by the NIDDK), and the National Institute of General Medical Sciences (grant no. U54 GM104940). J. L. D. is funded by the American Heart Association (grant: 20POST35210907); C. H. is funded by an NIH NIDDK Award (grant no. T32 DK064584).
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Dorling, Dr James
• Authors: Dorling, J., Hochsman, C., Fearnbach, S. N., Apolzan, J. W., Hsia, D. S., Johannsen, N. M., Church, T. S., and Martin, C. K.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Medicine and Science in Sports and Exercise
• Publisher: Lippincott, Williams & Wilkins
• ISSN: 0195-9131
• ISSN (Online): 1530-0315