EXERCISE FOR WEIGHT LOSS AND WEIGHT MAINTENANCE
The most successful programs for long-term weight control have involved combinations of diet, exercise, and behavior modification (22). Exercise alone, without concomitant dietary caloric restriction and behavior modification, tends to produce only modest weight loss of ∼2 kg. Weight loss is typically this small primarily because obese people often have difficulty performing sufficient exercise to create a large energy deficit, and it is relatively easy to counterbalance increased energy expenditure through exercise by eating more or becoming less active outside of exercise sessions (22). However, in a randomized trial, high-volume aerobic exercise (700 kcal/day, ∼1 h/day of moderate-intensity aerobic exercise) produced at least as much fat loss as the equivalent degree of caloric restriction and with greater resulting improvements in insulin sensitivity (23).