Intensive lifestyle counselling and exercise provide excellent long-term weight loss results for severely obese working-age people

A recent study from Oulu shows that lifestyle counselling alone and combined with exercise are effective tools for weight loss and long-term weight maintenance in severely obese working-age people. The most significant reduction in abdominal obesity, which is particularly detrimental to health, was achieved when lifestyle counselling was combined with exercise right at the start of weight loss. The treatment of obesity should include intensive, personalised lifestyle counselling and individually planned exercise, regardless of the level of obesity. 

The study was conducted in collaboration between the ODL Sports Clinic, the University of Oulu and Oulu University Hospital and published in the prestigious Scandinavian Journal of Medicine & Science in Sports.

The three-year study involved 120 severely obese working-age people. The average body mass index of the subjects at baseline was around 37 kg/m². The participants were divided into three different intervention groups and a control group. The members of the intervention groups received personalised lifestyle counselling, which included 14 meetings with a trainer or dietitian in the first year, four in the second year and two in the third year.

Two of the three intervention groups participated in a three-month guided exercise programme, which was carried out as heart-rate-controlled circuit weight training with air resistance fitness equipment. The resistance and target heart rate range were tailored to each subject’s personal fitness level. For one of the two groups, exercise was timed to begin immediately after the start of weight loss and for the other group, at six months after the start.

The aim for all the intervention groups was to achieve a significant weight loss of at least 5% in the first year and to maintain this over a two-year weight management period.

All three intervention groups managed to lose a significant amount of weight. The achieved weight loss was still significant in all groups after three years at the end of the follow-up.

The best results in weight management were achieved by the group that only received lifestyle counselling, with a 7% reduction in weight compared to the starting weight, and the group that started exercise right from the start, with a 6% reduction in weight. However, the participants who started exercising right from the start had the biggest reduction in waist circumference, which means they achieved the best results in reducing the harmful abdominal obesity.

Obesity is a significant public health problem

More and more Finns are becoming overweight or obese, and severe obesity and abdominal obesity in particular have increased in recent decades. In Finland, 63% of women and 72% of men over 30 years of age are overweight and one in four is obese (body mass index 30 kg/m² or more).

Obesity is a major problem in terms of public health and the economy, as obesity, and in particular abdominal obesity, is associated with a significant risk of cardiovascular diseases and premature death. Even a small, permanent weight loss of around 5% can bring significant health benefits. The risk of death decreases by one tenth when waist circumference is reduced by five centimetres.

“Lifestyle counselling, drug therapy and bariatric surgery are treatments for severe obesity, but only a fraction of people who meet the criteria for surgery are referred for it. This study confirms the key role of effective lifestyle counselling and properly planned exercise, including in weight loss and weight management for severely obese people,” says head researcher Kaisu Kaikkonen.

The model developed in the study provides new tools for healthcare providers. “Circuit weight training with air resistance fitness equipment is also ideal for people with severe obesity,” Kaikkonen points out.

Research publication: Kaikkonen KM, Korpelainen R, Vanhala ML, Keinänen-Kiukaanniemi SM, Korpelainen JT. Long-term effects on weight loss and maintenance by intensive start with diet and exercise. Scand J Med Sci Sports. 2023; 33: 246–256.

Last updated: 24.2.2023