Effects of Exercise, Diet, and a Combination of Exercise and Diet in Overweight and Obese Adults

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By Bettina Schaar1, Corinna Moos-Thiele2, and Petra Platen3

The Open Sports Medicine Journal, 2010

Excess weight and obesity and the resulting risk factors are major contributing factors to skyrocketing health-care costs. Between 3.9 and 10.33 billion euros are spent in Germany each year on treating obesity, which can lead to serious health problems such as diabetes, hypertension, and coronary heart disease. In a study incorporating data from medical examinations of men born in 1974 routinely conducted to assess fitness for military service, the German Federal Ministry of Health found that 154 out of 1000 men were slightly to moderately overweight and 15 were severely obese [1]. The prevalence of obesity has also increased dramatically in the U.S. during the last decade. An estimated 97 million American adults are overweight or obese, making obesity the nation’s second most common cause of preventable death [2].

Abstract: The objective of the following meta-analysis was to determine what kind of treatment, or combination of treatments, has the greatest effect on weight loss in overweight and obese adults.

A systematic search was conducted of the available literature published between 1993 and 2006 that covered randomized controlled trials on overweight and obese subjects who underwent treatment consisting of physical exercise and/ or changes in diet. The scope of the search thus incorporated seven relevant databases. Using 6,545 key word combinations, the electronic search yielded a total of 36,869 abstracts. 13 relevant studies with a total of 826 subjects (BMI > 25; 17 - 68 years of age) met the meta-analysis criteria. The courses of treatment included “diet (d)”, “physical exercise (pe)”, “diet and physical exercise (dpe)”, and “no intervention (ni)”. The results confirmed the hypothesis that the combined intervention “dpe” had the greatest effect with regard to weight loss. The single treatments “pe” and “d” also led to weight loss, with “d” having a significantly greater effect than “pe”. The main reason for the small sample size of thirteen studies out of 36,819 was that the experimental design and/or procedures of most studies were inadequate. A common error was a failure to assign subjects randomly to the different treatment groups. The results of our meta-analysis indicate that a combination of diet and physical exercise is the best form of treatment to induce weight loss in overweight individuals in the first weeks, followed by physical exercise to maintain weight loss.

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