The aim of this study was to explore how physical activity (PA) and energy intake (EI) changes were related to weight loss and regain following The Biggest Loser competition. At baseline, week 6 and week 30 of the competition, and 6 years after the competition, body composition was measured via dual-energy x-ray absorptiometry, resting energy expenditure was measured by using indirect calorimetry, and EI and PA were measured by using doubly labeled water. Six years after the competition, median weight loss in 14 of The Biggest Loser participants was 13%, with those maintaining a greater weight loss (meanSE) of 24.9%3.8% having increased PA by 160%23%, compared with a PA increase of 34%25% (P=0.0033) in the weight regainers who were 1.1%4.0% heavier than the precompetition baseline. EI changes were similar between weight loss maintainers and regainers (-8.7%5.6% vs. -7.4%2.7%, respectively; P=0.83). Weight regain was inversely associated with absolute changes in PA (r=-0.82; P=0.0003) but not with changes in EI (r=-0.15; P=0.61). EI and PA changes explained 93% of the individual weight loss variability at 6 years. Consistent with previous reports, large and persistent increases in PA may be required for long-term maintenance of lost weight.

Project Start
Project End
Budget Start
Budget End
Support Year
7
Fiscal Year
2018
Total Cost
Indirect Cost
Name
U.S. National Inst Diabetes/Digst/Kidney
Department
Type
DUNS #
City
State
Country
Zip Code
Hall, Kevin D (2018) Metabolic Adaptations to Weight Loss. Obesity (Silver Spring) 26:790-791
Kerns, Jennifer C; Guo, Juen; Fothergill, Erin et al. (2017) Increased Physical Activity Associated with Less Weight Regain Six Years After ""The Biggest Loser"" Competition. Obesity (Silver Spring) 25:1838-1843
Hall, Kevin D; Kerns, Jennifer C; Brychta, Robert et al. (2016) Response to ""Overstated metabolic adaptation after 'The Biggest Loser' intervention"". Obesity (Silver Spring) :
Fothergill, Erin; Guo, Juen; Howard, Lilian et al. (2016) Persistent metabolic adaptation 6 years after ""The Biggest Loser"" competition. Obesity (Silver Spring) 24:1612-9
Knuth, Nicolas D; Johannsen, Darcy L; Tamboli, Robyn A et al. (2014) Metabolic adaptation following massive weight loss is related to the degree of energy imbalance and changes in circulating leptin. Obesity (Silver Spring) 22:2563-9
Hall, Kevin D (2013) Diet versus exercise in ""the biggest loser"" weight loss competition. Obesity (Silver Spring) 21:957-9
Johannsen, Darcy L; Knuth, Nicolas D; Huizenga, Robert et al. (2012) Metabolic slowing with massive weight loss despite preservation of fat-free mass. J Clin Endocrinol Metab 97:2489-96