Exercise in the maintenance of weight loss: health benefits beyond lost weight on the scale

• Published in: British journal of sports medicine 2022-07, Vol.56 (13), p.771-772
• Main Authors: D'Souza, Alysha C, Lau, Kyle J, Phillips, Stuart M
• Format: Article
• Language: English
• Subjects: Body composition; Cardiovascular disease; Councils; Discussion; Exercise; health; Heart rate; Mental health; Metabolism; Mortality; Obesity; Overweight; Physical fitness; Weight control; weight loss
• ISSN: 0306-3674; 1473-0480
• DOI: 10.1136/bjsports-2021-104754

Simply focusing only on lost weight undermines the numerous health advantages of exercise, including better mental health, the composition of lost weight and, importantly, improved fitness.2 Body composition Bodyweight comprises two components: fat mass and fat-free mass (FFM), consisting of bone and lean soft-tissue mass.3 Much of the obesity-related disease risk is associated with fat mass and, more specifically, visceral fat, which is an undesirable location to accrue body fat. A reduction in FFM, especially skeletal muscle, can have negative metabolic consequences, including weight regain.4 Thus, weight loss and maintenance should focus on changes in body composition and the loss of visceral fat and relative preservation of muscle mass. Additionally, compared with baseline, the exercise group was the only active treatment with increases in lean mass, which may be important for long-term metabolic health and, potentially, to maintain lost weight.4 Cardiovascular outcomes Poor cardiorespiratory fitness (CRF), often associated with obesity, is an independent risk factor for cardiovascular disease (CVD) and mortality.5 Thus, people with obesity should be encouraged to increase their physical activity to enhance CRF as it can greatly reduce the adverse effects of excess fat mass and other traditional CVD risk factors even in the absence of weight loss.6 As expected, only the exercise and combination groups exhibited increased CRF.6 In our view, improvements in CRF should be viewed as being virtually equivalent in importance to weight loss itself since increases in CRF are associated with lower rates of all-cause mortality and CVD.1 Resting heart rate (HR) is another risk factor for CVD and all-cause mortality.7 This risk increases continuously with resting HR above 60 beats/min.7 Unsurprisingly, treatment groups began the intervention with an average resting HR above 60 beats/min.