A systematic review and meta-analysis of 11 randomized controlled trials (568 participants) found that exercise during the weight-maintenance phase reduced weight regain by an average of 2.81 kg compared to control groups. However, the effect on fat mass was not statistically significant.
Key Findings
Weight Regain
A pooled analysis of 9 studies showed a mean difference of -2.81 kg (95% CI: -5.12 to -0.51), favoring the exercise group.
Fat Mass
A pooled analysis of 6 studies showed a mean difference of -3.39 kg (95% CI: -7.24 to 0.46; P=0.08), which was not statistically significant.
Adherence
No significant difference was found between exercise and control groups (risk ratio 0.94; 95% CI: 0.85 to 1.03).
Methodology
- Design: Systematic review and meta-analysis, registered in PROSPERO (CRD420251240526).
- Databases searched: PubMed, Embase, Web of Science, Cochrane Library, and China National Knowledge Infrastructure (inception to October 19, 2025).
- Inclusion criteria: English-language randomized controlled trials of adults with BMI >25 kg/m² who had achieved weight loss via diet, pharmacotherapy, or bariatric surgery, and subsequently underwent an exercise intervention during maintenance.
- Primary outcome: Weight regain defined as net change from pre-weight-loss baseline.
- Risk of bias: Assessed using the revised Cochrane Risk of Bias Tool; some concerns and high-risk judgments were identified.
Limitations
- Small number of trials (11) and participants (568).
- Heterogeneity in exercise type, dose, duration, and adherence definitions.
- Older evidence (studies published 1996–2023).
- Inability to reliably assess publication bias due to the small number of studies.
Conclusion
The authors conclude that exercise offers a modest benefit in reducing weight regain, but evidence for fat mass reduction remains inconclusive. They call for longer, more standardized trials.