Increased physical activity was associated with less weight regain six years after “The Biggest Loser” competition

Abstract

Objective

To explore how physical activity (PA) and energy intake (EI) changes were related to weight loss and regain following the Biggest Loser competition.

Methods

At baseline, six weeks, 30 weeks, and six years after the competition we measured body composition via dual energy X-ray absorptiometry, resting energy expenditure using indirect calorimetry, and EI and PA using doubly labeled water.

Results

Six years after the competition, median weight loss in 14 Biggest Loser participants was 13%, with those maintaining greater weight loss (mean ± SE) of 24.9 ± 3.8% having increased PA by 160 ± 23% compared to a PA increase of 34 ± 25 % (p = 0.0033) in the weight regainers who were 1.1 ± 4.0% heavier than the pre-competition 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 six years.

Conclusions

Consistent with previous reports, large persistent increases in physical activity may be required for long-term maintenance of lost weight.