부산대학교 도서관

INTRODUCTION: This 24-month study aimed to determine if exercise intervention added to weight loss treatment at 6 months is effective for weight loss and maintenance. METHODS: A total of 120 obese subjects (BMI > 30) were randomly assigned to behavioural modification (iBM) (n = 30), behavioural modification + exercise from 0 to 3 months (CWT1) (n = 30), behavioural modification + exercise from 6 to 9 months (CWT2) (n = 30), and a control group (CON) (n = 30). Health behavior, weight, waist circumference, and 2-hour glucose tolerance test with insulin measurements were measured at 0, 3, 9, and 24 months. RESULTS: Eighty-five subjects (mean age 46 years, BMI 36.3, 75.3% women) completed the trial. A significant weight loss occurred in CWT1 (−8.5 kg, p > 0.001), iBM (−5.5 kg, p > 0.001), and CWT2 (−4.4 kg, p = 0.007). CWT1 showed the highest reduction in waist circumference at 9 months (mean difference −11.5 cm, p < 0.001) and 24 months (mean difference −8.8 cm, p < 0.001). Both fasting and 2-hour insulin values improved in the intervention groups compared with CON. A significant decrease in 2-hour insulin values from baseline was found in CWT1 and CWT2. Matsuda Index improved in the CWT1 group from the baseline to 24 months (2.03p = 0.025). CONCLUSION: The most effective weight loss regimen is a combination of intensified behavioural modification and weight training introduced from the very beginning of the weight loss period. Treatment of morbid obesity should include an intensive start with exercise and diet regardless of weight status.