University of Oulu

Kaikkonen, KM, Korpelainen, R, Vanhala, ML, Keinänen-Kiukaanniemi, SM, Korpelainen, JT. Long-term effects on weight loss and maintenance by intensive start with diet and exercise. Scand J Med Sci Sports. 2023; 33: 246-256. doi: 10.1111/sms.14269

Long-term effects on weight loss and maintenance by intensive start with diet and exercise

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Author: Kaikkonen, Kaisu M.1,2,3; Korpelainen, Raija1,2,3; Vanhala, Marja L.1;
Organizations: 1Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., Oulu, Finland
2Research Unit of Population Health, University of Oulu, Faculty of Medicine, Oulu, Finland
3Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
4Unit of Primary Health Care, Oulu University Hospital, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.2 MB)
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Language: English
Published: John Wiley & Sons, 2023
Publish Date: 2023-08-10


This 36-month study aimed to determine whether exercise intervention added to weight loss treatment in the beginning or at 6 months is effective for weight loss and long-term weight maintenance. A total of 120 obese adults (body mass index >30) were randomly assigned to intensified behavioral modification (iBM), iBM+ additional exercise from 0 to 3 months (CWT1), iBM+ additional exercise from 6 to 9 months (CWT2), and a control group (CON). Questionnaires and measurements were collected at baseline, 3, 9, 24, and 36 months. The intervention consisted of an 12 months intensified weight-loss period followed by a 24 months weight-maintenance period. Eighty (67%) subjects (mean age 46.0 years, BMI 36.2) completed the trial. Compared with the control group, all three intervention groups had significant weight loss during the 36-month intervention period (p < 0.001). The achieved weight loss remained significant at 36 months in the iBM (−6.8%, p < 0.001), the CWT1 (−5.8%, p < 0.001), and the CWT2 group (−3.9%, p < 0.001). The CWT1 group showed significant reduction in waist circumference at 9 months (−11.3 cm, p < 0.001), at 24 months (−8.8 cm, p < 0.001), and at 36 months (−8.7 cm, p < 0.001). Intensified behavioral modification alone and with exercise resulted in clinically significant weight loss and long-term weight maintenance. The addition of exercise at the onset promoted greater reductions in waist circumference. In the treatment of obesity, including severe obesity, more intensive lifestyle interventions with exercise should be incorporated.

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Series: Scandinavian journal of medicine & science in sports
ISSN: 0905-7188
ISSN-E: 1600-0838
ISSN-L: 0905-7188
Volume: 33
Issue: 3
Pages: 246 - 256
DOI: 10.1111/sms.14269
Type of Publication: A1 Journal article – refereed
Field of Science: 3142 Public health care science, environmental and occupational health
Funding: This study was supported financially by the Ministry of Culture and Education, Finland. KMK was funded by the Juho Vainio Foundation, Finland. The funders played no role in designing the study, or collecting, analyzing, and interpreting the data, or writing the manuscript.
Copyright information: © 2022 The Authors. Scandinavian Journal of Medicine & Science In Sports published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.