Changes in Body Composition, Cardiovascular Disease Risk Factors, and Eating Behavior after an Intensive Lifestyle Intervention with High Volume of Physical Activity in Severely Obese Subjects: A Prospective Clinical Controlled Trial

Abstract

We examined the effects of a 10–14-weeks inpatient lifestyle modification program, including minimum 90 min of physical activity (PA) five days/week, on body composition, CVD risk factors, and eating behavior in 139 obese subjects (BMI42.6±5.2 kg/m2). Completion rate was 71%(n=71)in the intensive lifestyle intervention (ILI) group and 85%(n=33)among waiting list controls. Compared to controls body weight (-17.0(95% CI: -18.7,-15.3) kg,P<0.0001), fat mass (-15.2(95% CI: -17.4,-13.1) kg,P<0.0001), fat free mass (-1.2(95% CI: -2.2,-0.2) kg,P=0.016) and visceral fat (-86.6(95% CI: -97.4,-75.7) cm2,P<0.0001) were reduced in the ILI-group after 10–14 weeks. Within the ILI-group weight loss was-23.8(95% CI: -25.9,-21.7) kg,P<0.0001and-20.3(95% CI: -23.3,-17.3) kg,P<0.0001, after six and 12 months, respectively. Systolic BP, glucose, triglycerides, and LDL-C were reduced, and HDL-C was increased (allP≤0.006) after 10–14 weeks within the ILI group. The reduction in glucose and increase in HDL-C were sustained after 12 months (allP<0.0001). After one year, weight loss was related to increased cognitive restraint and decreased uncontrolled eating (allP<0.05). Thus, ILI including high volume of PA resulted in weight loss with almost maintenance of fat-free mass, favorable changes in CVD risk factors, and eating behavior in subjects with severe obesity.