Physical Activity, Weight Loss, and Weight Maintenance in the DiOGenes Multicenter Trial

Abstract

In this secondary analysis of the DiOGenes study, we investigated whether physical activity (PA) contributes to diet-induced weight loss and helps to reduce subsequent regain. We also studied the associations of PA with changes in cardiometabolic variables. Adults with overweight were included and followed an 8-week low-calorie diet (LCD). When successful (>8% weight loss), participants were randomized to different ad libitum diet groups and were advised to maintain their weight loss over the 6-month intervention period. Body weight (BW), body composition, cardiometabolic variables and subjectively-assessed PA were measured at baseline, at the end of weight loss and at the end of the intervention. BW was reduced by the LCD (from 99.8 ± 16.7 to 88.4 ± 14.9 kg; P < 0.001). This reduction was maintained during the weight maintenance period (89.2 ± 16.0 kg). Total PA (sum score of the three subscales of the Baecke questionnaire) increased during the weight loss period (from 8.16 ± 0.83 to 8.39 ± 0.78; P < 0.001) and this increase was subsequently maintained (8.42 ± 0.90). We found no evidence that baseline PA predicted weight loss. However, a higher level of baseline PA predicted a larger weight-loss-induced improvement in total cholesterol, triglycerides, glucose and CRP, and in post-prandial insulin sensitivity (Matsuda index). Subsequent weight and fat mass maintenance were predicted by the post-weight loss level of PA and associated with changes in PA during the weight maintenance phase. In conclusion, despite the fact that higher baseline levels of PA did not predict more weight loss during the LCD, nor that an increase in PA during the LCD was associated with more weight loss, higher PA levels were associated with more improvements in several cardiometabolic variables. The positive effect of higher PA on weight loss maintenance seems in contrast to randomized controlled trials that have not been able to confirm a positive effect of exercise training programmes on weight loss maintenance. This analysis supports the notion that higher self-imposed levels of PA may improve the cardiometabolic risk profile during weight loss and help to maintain weight loss afterwards.

Long‐term preservation of lean mass and sustained loss of fat mass after completion of an intensive lifestyle intervention in older adults with obesity and type 2 diabetes

“…More specifically, we observed a sustained loss of fat mass, which has, for example, been observed in the DiOGenes trial in adults with overweight or obesity 6 months after an 8‐week low‐calorie diet. However, the loss of fat‐free mass in that study was about 20% of the body weight lost 27 . To our knowledge, sustained fat mass loss with maintained or improved lean mass has not been reported before in older adults with obesity and type 2 diabetes.…”

“…However, the loss of fat-free mass in that study was about 20% of the body weight lost. 27 To our knowledge, sustained fat mass loss with maintained or improved lean mass has not been reported before in older adults with obesity and type 2 diabetes.…”

Could semaglutide promote lifestyle interventions? Influence of semaglutide among people living with overweight/obesity on weight loss and physical activity in a real-world scenario

“…The authors suggested that non-adherence or lack of willpower are exclusive among PwO is false and this belief may perpetuate weight bias and stigma [27]. In a secondary analysis of the DiOGenes study, they found that higher selfimposed levels of physical activity may improve the cardiometabolic risk profile during weight loss and help maintain weight loss in the long term [28]. Moreover, in a systematic review and metanalysis they found that the increase in physical activity is the most consistent positive correlate of weight loss maintenance [29].…”

Obesity Intervention in Sub-Saharan Africa: A systematic review protocol

“…Several interventions are currently used to manage weight in cases of obesity, which usually focused on implementing lifestyle changes that include physical activity and dietary recommendations [9], [33]- [35]. Nevertheless, there are mixed evidence on the effectiveness of these interventions [7], [36]- [40] which remains a major challenge in the fight against obesity especially in SSA. Additionally, there is paucity of studies on the obesity and the effectiveness of the available obesity interventions in SSA [38], [41]- [46].…”