James J. Annesi by James J. Annesi

For more than two decades, regular participation in physical activity/exercise has been recognized as the strongest predictor of maintained weight loss in adults with overweight and obesity. Recommendations from the U.S. Department of Health & Human Services and the World Health Organization suggest a minimum of 150 to 300 minutes of moderate-intensity physical activity each week. However, it's worth noting that in determining the number of Americans who achieve even the lower end of that range, one piece of research found that only 6 to 8% of adolescents and 5% of adults do so, while another study put that number at 10% for adults. That percentage is even smaller for individuals struggling with excess weight 

These commonly cited exercise recommendations may be achievable for only a small percentage of those who need it most. Health coaches and exercise professionals sometimes program large amounts of exercise and then place the blame on clients for their lack of “motivation” or “willpower” when they fail to adhere. This is an outdated and ineffective approach. Today's exercise professionals should be adept at facilitating behavioral changes, along with providing solid advice on effective exercise techniques. 

My own research explores the link between exercise volumes and weight loss in non-surgical, non-medication obesity programs. Despite previous assumptions about exercise and weight loss, three or four moderate-intensity exercise sessions per week were shown to be as effective for weight loss as five to seven sessions. Participants lost an average of more than 6% of their initial weight over six monthsa good result given that a 5% weight loss is usually considered beneficial for reducing health risks. In other words, exercising moderately three to four days per week brought about the same results as working out more often 

Another study I recently completed showed good weight-loss results associated with various exercise-related psychological changes, with no weight-reduction differences in groups completing the equivalent of three, four, five, six, seven, or more than seven moderate-intensity exercise sessions per week. 

So, if the amount of exercise is not the key to losing weight, why is exercise such a strong predictor of weight loss? Based on the above findings, I believe exercise serves as a platform for psychological changes that enhance control over eating habits and promote sustainable weight loss. 

Over the past 25+ years, I've investigated which psychological changes are induced by moderate amounts of exercise and which are most beneficial for weight loss. These observed changes encompassed factors including body image, self-concept, propensity for emotional eating and even coping mechanisms. However, improvements in self-regulation, overall mood and self-efficacy (confidence in one's abilities) proved to be the most effective.  

  • Self-regulation, or the ability to manage one's behavior, was the most significant predictor of weight-loss success. As participants began their exercise routines, they developed better self-regulation skills, and were able to overcome challenges like lack of time, discomfort and slow progress. When these skills are supported by health and exercise professionals, they could be easily adapted for controlling eating and achieving weight loss.  

  • Exercise also improves mood. Despite suggestions that the 150 minutes of moderate- intensity exercise per week required for physical health benefits is also necessary for mental health, my research showed substantial mood improvements with 2.5 to three exercise sessions per week averaging 15 to 20 minutes/session (approximately 40 to 60 minutes of moderate-intensity exercise/week). These mood enhancements also led to improvements in emotional eating and subsequent weight loss. 

  • Lastly, increased self-efficacy, or the belief in one's ability to overcome obstacles and achieve goals, was linked to successful weight loss. When participants felt capable of maintaining their exercise routines despite challenges, they were also more likely to control their eating, especially if they had previously struggled with weight loss. 

Based on these findings, I recommend that health coaches and exercise professionals: 

  • Empower clients with the self-regulation skills needed for consistent exercise and improved eating. 

  • Emphasize the importance of consistent moderate exercise to improve clients’ mood. Also, use a standardized form to track mood improvements, providing extra motivation for clients to continue exercising. 

  • Guide clients in applying their newly developed self-regulation skills to overcome challenges and barriers to both exercise and controlled eating, which can boost their self-efficacy.  

In summary, only about 16% of weight loss in adults with overweight and obesity can be directly attributed to the calories burned during exercise. However, exercise clearly plays a pivotal role in weight loss, serving as a strong predictor of success. The reason lies not only in physical exertion, but also in the psychological changes that accompany regular physical activity/exercise. Exercise is closely tied to the psychological factors that influence changes in eating behavior, such as improved self-regulation, mood enhancements and increased self-efficacy.  

For health coaches and exercise professionals, these findings underscore the importance of equipping clients with the skills and mindset to effectively incorporate exercise into their lifestyles. Instead of focusing solely on the physical aspects of exercise, professionals should also leverage its psychological impacts. By emphasizing self-regulation skills, tracking mood improvements and promoting self-efficacy, professionals can provide comprehensive support to their clients on their journey to better health and sustainable weight loss. This holistic approach to health and wellness offers promising potential for long-term success. 

To learn more from Dr. James Annesi about how to support clients as they pursue sustained weight loss, reserve your spot to attend his free webinar: A Self-regulation Approach to Weight Management. During this two-hour event, Dr. Annesi will explore psychosocial changes associated with adhering to a program of moderate exercise and how they can transfer to changes associated with controlled eating and long-term weight maintenance. 


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