Increased Physical Activity Associated with Less Weight Regain Six Years After "The Biggest Loser" Competition

Abstract

Objective: 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.

Methods: 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.

Results: Six years after the competition, median weight loss in 14 of "The Biggest Loser" participants was 13%, with those maintaining a greater weight loss (mean ± SE) 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.

Conclusions: Consistent with previous reports, large and persistent increases in PA may be required for long-term maintenance of lost weight.

Trial registration: ClinicalTrials.gov NCT02544009.

Figure 1

Six years after the Biggest Loser competition, the median percent weight loss compared to the pre-competition baseline was 13%. The increase in physical activity from baseline to six years was significantly higher in the seven weight loss maintainers (160 ± 23%) compared to the seven weight regainers (34 ± 25 %; p = 0.0033), while the percent change in energy intake did not significantly differ between weight loss maintainers and regainers (−8.7 ± 5.6% vs −7.4± 2.7 %, respectively; p=0.83).

Figure 2

Individual changes in absolute (A) energy intake, and (B) physical activity from pre-competition baseline to six years after the Biggest Loser competition were both significantly correlated with weight loss six years after the competition.

Figure 3

(A) Energy intake changes were not significantly correlated with weight regained in the six years after the Biggest Loser competition. (B) Physical activity changes were significantly inversely related to weight regained.

Figure 4

Neither the weight lost at six weeks (A), nor 30 weeks (B) was significantly associated with physical activity changes from the pre-competition baseline. Changes in energy intake were significantly correlated with weight loss after both six weeks (C) and 30 weeks (D).