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Exercise Key to Maintaining Weight Loss in Obesity

Article reviews non-surgical approach to obesity

WEDNESDAY, April 30 (HealthDay News) -- While caloric restriction leads to short-term weight loss, increases in physical activity may be necessary to overcome the body's tendency to re-establish the original body weight and prevent weight regain, according to an article in the May 1 issue of the New England Journal of Medicine.

Robert H. Eckel, M.D., of the University of Colorado Denver in Aurora, reviews the evidence supporting non-surgical treatments of obesity in adults.

First-line treatments include lifestyle approaches such as diet and physical activity, and behavioral modifications such as goal setting, self-monitoring and stimulus control. Pharmacologic therapy as an adjunct to lifestyle modification is recommended for individuals with a body mass index (BMI) above 30 or a BMI above 27 accompanied by obesity-related disease, the report indicates. Four drugs have been approved by the U.S. Food and Drug Administration (phentermine, diethylpropion, orlistat and sibutramine) that may modestly improve the rate of weight loss. Overcoming the body's metabolic programming to return to the original body weight is a key challenge in the treatment of obesity, the author notes.

"The long-term maintenance of weight reduction is difficult, as multiple mechanisms exist to modify energy balance to re-establish the original body weight," Eckel writes. "Prospective observational data suggest that physical activity of moderate intensity (brisk walking) for approximately 80 minutes per day or vigorous activity (jogging) for 35 minutes per day, expending about 2500 kcal per week, is protective against weight regain."

Eckel reports receiving lecture fees and grant support from several pharmaceutical companies.

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