ABSTRACT
In this chapter we address two primary questions: Is energy expenditure (EE) from exercise associated with reductions in both total and abdominal obesity? Is there a positive dose–response relationship in adults with overweight or obesity? We also consider the separate effects of exercise amount and intensity on obesity, and whether post-exercise oxygen consumption (EPOC) makes a meaningful contribution to exercise-induced EE. We restricted our electronic search to peer-reviewed evidence from randomized controlled trials published between 2012 and 2021. A total of 16 studies were retrieved, 10 of which compared the effects of a single exercise intervention to controls, and 6 that randomized participants to at least two exercise interventions varying substantially in exercise-induced EE. There were two primary findings: With few exceptions, exercise EE was associated with significant reductions in total and abdominal obesity. When the reductions in body weight and total body fat across studies that randomized participants to a single exercise dose were considered, a dose–response association was observed. Paradoxically, the findings from all six randomized trials specifically designed to determine dose–response relationships found no between-group differences for markers of total or abdominal obesity. Recommendations are made with a view to improving the design of trials that aim to determine the utility of exercise alone as a strategy for managing obesity.
