GA Gaesser, SS Angadi. iScience 2021; https://doi.org/10.1016/j.isci.2021.102995. Open access: Obesity treatment: Weight loss versus increasing fitness and physical activity for reducing health risks

Key points from this review of more than 200 relevant meta-analyses and individual studies:

• “A weight-neutral approach to treating obesity-related health conditions may be as, or more, effective than a weight-loss-centered approach, and could avoid pitfalls associated with repeated weight loss failure… Epidemiological studies show that CRF (cardiorespiratory fitness) and PA (physical activity) significantly attenuate, and sometimes eliminate, the increased mortality risk associated with obesity. More importantly, increasing PA or CRF is consistently associated with greater reduction in risk of all-cause and CVD mortality than intentional weight loss.”
• “The increased prevalence of weight loss attempts in the United States has coincided with the increased prevalence of obesity. Thus, a weight-centric approach to obesity treatment and prevention has been largely ineffective. It is unlikely that continued focus on weight loss as the primary metric for success will reverse the trends in obesity prevalence or result in sustainable weight loss. In fact, chronic weight cycling is the norm for millions of adults and is likely to remain so for as long as weight loss persists as the cornerstone of obesity treatment. Weight cycling is associated with health risks that are very similar to those associated with obesity, including higher all-cause mortality risk, and may contribute to weight gain.”

NY Times (9/29/21): Why Exercise Is More Important Than Weight Loss for a Longer Life “People typically lower their risks of heart disease and premature death far more by gaining fitness than by dropping weight.”

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