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Evidence for Success of Exercise in Weight Loss and Control

Steven N. Blair, PED
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From the Cooper Institute for Aerobics Research, Dallas, Texas. Requests for Reprints: Steven N. Blair, PED, Cooper Institute for Aerobics Research, 12330 Preston Road, Dallas, TX 75230. Acknowledgments: The author thanks Laura Becker for manuscript and figure preparation. Grant Support: In part by U.S. Public Health Service research grant AG06945 from the National Institute on Aging, Bethesda, Maryland.

Copyright 2004 by the American College of Physicians

Ann Intern Med. 1993;119(7_Part_2):702-706. doi:10.7326/0003-4819-119-7_Part_2-199310011-00015
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Physically active men and women may be less likely than their sedentary peers to become overweight. Caloric restriction in overweight persons produces larger weight losses than does exercise, although more of the weight loss by dieting is from lean body mass. The addition of exercise to diet intervention produces more weight loss than does dieting alone. Exercise has a favorable effect on body fat distribution, with a reduction in waist-to-hip ratio with increased exercise. Exercise is especially important in maintaining weight loss in overweight persons. Several prospective studies have shown that overweight men and women who are active and fit have lower rates of morbidity and mortality than overweight persons who are sedentary and unfit. Therefore, exercise is of benefit to overweight persons, even if it does not make them lean. Exercise is recommended as an important part of a weight control program.


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Figure 2.
Incidence of diabetes mellitus and death rates in overweight persons by degree of physical activity and physical fitness. Top.[16][15]Middle.2[18]Bottom.2[19]

Non-insulin-dependent diabetes mellitus rates in overweight women by categories of weekly vigorous exercise and in overweight men by strata of a physical activity index measured in kcal/week. All-cause death rates by physical fitness categories for women and men with a body mass index (BMI) greater than 25 kg/m in the Aerobics Center Longitudinal Study . All-cause death rates in men with a BMI greater than 25.4 kg/m by strata of a physical activity index measured in kcal/wk .

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Figure 1.
Weight loss and gain by exercise status over 8 weeks of intervention and 18 months of follow-up.

Patients were randomly assigned to treatment groups for the intervention phase. Cross-over to the other treatment condition occurred throughout follow-up as a natural experiment. The numbers in parentheses indicate the number of participants who crossed over at each time point. For example, of the 54 patients in the exercise group at the end of 8 weeks of intervention, 44 continued to exercise at 8 months, and 10 had become nonexercisers. (From reference 14 with permission.).

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