Many overweight and obese individuals use exercise when attempting to lose weight. However, the improvements in weight and body composition are often far less than expected. Levels of physical activity outside of the structured exercise program are believed to change and may be responsible for the unsuccessful weight loss.
The purpose of this meta-analysis was to provide a quantitative estimate of the change in non-exercise physical activity (NEPA) during exercise interventions.
All studies included in the meta-analysis were peer-reviewed and published in English. Participants were randomized to a non-exercise comparison group or exercise training group with an intervention lasting ≥2 weeks. NEPA was measured at baseline and at various times during the study. Hedges’ d effect size (ES) was used to adjust for small sample bias, and random-effects models were used to calculate the mean ES and explore potential moderators.
The cumulative results of 44 effects gathered from ten studies published between 1997 and 2015 indicated that NEPA did not change significantly during exercise training (ES = 0.02, 95% confidence interval [CI] −0.09 to 0.13; p = 0.723). Duration of the exercise session (β = −0.0039), intervention length (β = 0.0543), and an age × sex (β = −0.0005) interaction indicated that the increase in NEPA may be attenuated in older women during exercise training and during shorter exercise interventions with longer sessions (all p < 0.005).
On average, no statistically or clinically significant mean change in NEPA occurs during exercise training. However, session duration and intervention length, age, and sex should be accounted for when designing exercise programs to improve long-term sustainability and improve the likelihood of weight loss success, as the initial decrease in NEPA appears to dissipate with continued training.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Tsai AG, Williamson DF, Glick HA. Direct medical cost of overweight and obesity in the USA: a quantitative systematic review. Obes Rev. 2011;12(1):50–61.
Kelly T, Yang W, Chen C, et al. Global burden of obesity in 2005 and projections to 2030. Int J Obes (Lond). 2008;32(9):1431–7.
Klem ML, Wing RR, McGuire MT, et al. A descriptive study of individuals successful at long-term maintenance of substantial weight loss. Am J Clin Nutr. 1997;66(2):239–46.
Thorogood A, Mottillo S, Shimony A, et al. Isolated aerobic exercise and weight loss: a systematic review and meta-analysis of randomized controlled trials. Am J Med. 2011;124(8):747–55.
Ross R, Janssen I. Physical activity, total and regional obesity: dose-response considerations. Med Sci Sports Exerc. 2001;33(6 Suppl):S521–7 (discussion S8–9).
Swift DL, Johannsen NM, Lavie CJ, et al. The role of exercise and physical activity in weight loss and maintenance. Prog Cardiovasc Dis. 2014;56(4):441–7.
Ross R, Dagnone D, Jones PJ, et al. Reduction in obesity and related comorbid conditions after diet-induced weight loss or exercise-induced weight loss in men. A randomized, controlled trial. Ann Intern Med. 2000;133(2):92–103.
Ross R, Janssen I, Dawson J, et al. Exercise-induced reduction in obesity and insulin resistance in women: a randomized controlled trial. Obes Res. 2004;12(5):789–98.
King NA, Hopkins M, Caudwell P, et al. Individual variability following 12 weeks of supervised exercise: identification and characterization of compensation for exercise-induced weight loss. Int J Obes (Lond). 2008;32(1):177–84.
Donnelly JE, Honas JJ, Smith BK, et al. Aerobic exercise alone results in clinically significant weight loss for men and women: midwest exercise trial 2. Obesity (Silver Spring). 2013;21(3):E219–28.
Melanson EL, Keadle SK, Donnelly JE, et al. Resistance to exercise-induced weight loss: compensatory behavioral adaptations. Med Sci Sports Exerc. 2013;45(8):1600–9.
Herrmann SD, Willis EA, Honas JJ, et al. Energy intake, nonexercise physical activity, and weight loss in responders and nonresponders: The Midwest Exercise Trial 2. Obesity (Silver Spring). 2015;23(8):1539–49.
Donnelly JE, Smith BK. Is exercise effective for weight loss with ad libitum diet? Energy balance, compensation, and gender differences. Exerc Sport Sci Rev. 2005;33(4):169–74.
Byrne NM, Wood RE, Schutz Y, et al. Does metabolic compensation explain the majority of less-than-expected weight loss in obese adults during a short-term severe diet and exercise intervention? Int J Obes (Lond). 2012;36(11):1472–8.
Pontzer H. Constrained total energy expenditure and the evolutionary biology of energy balance. Exerc Sport Sci Rev. 2015;43(3):110–6.
Pontzer H, Durazo-Arvizu R, Dugas LR, et al. Constrained total energy expenditure and metabolic adaptation to physical activity in adult humans. Curr Biol. 2016;26(3):410–7.
Ravussin E, Peterson CM. Physical activity and the missing calories. Exerc Sport Sci Rev. 2015;43(3):107–8.
Kelly AS. Debunking the myth: exercise is an effective weight loss treatment. Exerc Sport Sci Rev. 2015;43(1):2.
Garland T, Schutz H, Chappell MA, et al. The biological control of voluntary exercise, spontaneous physical activity and daily energy expenditure in relation to obesity: human and rodent perspectives. J Exp Biol. 2011;214(Pt 2):206–29.
Donnelly JE, Blair SN, Jakicic JM, et al. American College of Sports Medicine Position Stand. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc. 2009;41(2):459–71.
Drenowatz C. Reciprocal compensation to changes in dietary intake and energy expenditure within the concept of energy balance. Adv Nutr. 2015;6(5):592–9.
Manthou E, Gill JM, Wright A, et al. Behavioural compensatory adjustments to exercise training in overweight women. Med Sci Sports Exerc. 2010;42(6):1121–8.
Church TS, Martin CK, Thompson AM, et al. Changes in weight, waist circumference and compensatory responses with different doses of exercise among sedentary, overweight postmenopausal women. PLoS One. 2009;4(2):e4515.
Hopkins M, Gibbons C, Caudwell P, et al. The adaptive metabolic response to exercise-induced weight loss influences both energy expenditure and energy intake. Eur J Clin Nutr. 2014;68(5):581–6.
Thomas DM, Bouchard C, Church T, et al. Why do individuals not lose more weight from an exercise intervention at a defined dose? An energy balance analysis. Obes Rev. 2012;13(10):835–47.
Kozey-Keadle S, Staudenmayer J, Libertine A, et al. Changes in sedentary time and physical activity in response to an exercise training and/or lifestyle intervention. J Phys Act Health. 2014;11(7):1324–33.
Colley RC, Hills AP, King NA, et al. Exercise-induced energy expenditure: implications for exercise prescription and obesity. Patient Educ Couns. 2010;79(3):327–32.
King NA, Horner K, Hills AP, et al. Exercise, appetite and weight management: understanding the compensatory responses in eating behaviour and how they contribute to variability in exercise-induced weight loss. Br J Sports Med. 2012;46(5):315–22.
Washburn RA, Lambourne K, Szabo AN, et al. Does increased prescribed exercise alter non-exercise physical activity/energy expenditure in healthy adults? A systematic review. Clin Obes. 2014;4(1):1–20.
Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339:332–6.
Church TS, Earnest CP, Skinner JS, et al. Effects of different doses of physical activity on cardiorespiratory fitness among sedentary, overweight or obese postmenopausal women with elevated blood pressure: a randomized controlled trial. JAMA. 2007;297(19):2081–91.
Van Etten LM, Westerterp KR, Verstappen FT, et al. Effect of an 18-wk weight-training program on energy expenditure and physical activity. J Appl Physiol (1985). 1997;82(1):298–304.
Meijer EP, Westerterp KR, Verstappen FT. Effect of exercise training on total daily physical activity in elderly humans. Eur J Appl Physiol Occup Physiol. 1999;80(1):16–21.
Meijer EP, Westerterp KR, Verstappen FT. Effect of exercise training on physical activity and substrate utilization in the elderly. Int J Sports Med. 2000;21(7):499–504.
Hedges L, Olkin I. Statistical methods for meta-analysis. 6th ed. San Diego: Academic Press; 1985. p. 79–201.
Rosenthal R. The, “file drawer problem” and tolerance for null results. Psychol Bull. 1979;86(3):638–41.
Willis EA, Herrmann SD, Honas JJ, et al. Nonexercise energy expenditure and physical activity in the Midwest Exercise Trial 2. Med Sci Sports Exerc. 2014;46(12):2286–94.
Lipsey MW, Wilson DB. Practical meta-analysis. Newbury Park: Sage Publications; 2001.
Rosenthal R. Meta-analytic procedures for social research. 2nd ed. Newbury Park: SAGE Publications; 1991.
Egger M, Smith G, Schneider M, et al. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315(7109):629–34.
Hox J. Multilevel analysis: techniques and applications, 2 edn. Marcoulides G, editor. New York: Taylor & Francis; 2010: pp. 205–32.
Singer JD, Using SAS. PROC MIXED to fit multilevel models, hierarchical models, and individual growth models. J Educ Behav Stat. 1998;23(4):323–55.
Turner JE, Markovitch D, Betts JA, et al. Nonprescribed physical activity energy expenditure is maintained with structured exercise and implicates a compensatory increase in energy intake. Am J Clin Nutr. 2010;92(5):1009–16.
Wang X, Lyles MF, You T, et al. Weight regain is related to decreases in physical activity during weight loss. Med Sci Sports Exerc. 2008;40(10):1781–8.
Rosenkilde M, Auerbach P, Reichkendler MH, et al. Body fat loss and compensatory mechanisms in response to different doses of aerobic exercise—a randomized controlled trial in overweight sedentary males. Am J Physiol Regul Integr Comp Physiol. 2012;303(6):R571–9.
Rangan VV, Willis LH, Slentz CA, et al. Effects of an 8-month exercise training program on off-exercise physical activity. Med Sci Sports Exerc. 2011;43(9):1744–51.
Hollowell RP, Willis LH, Slentz CA, et al. Effects of exercise training amount on physical activity energy expenditure. Med Sci Sports Exerc. 2009;41(8):1640–4.
Higgins JP. Commentary: heterogeneity in meta-analysis should be expected and appropriately quantified. Int J Epidemiol. 2008;37(5):1158–60.
Higgins J, Thompson S, Deeks J, et al. Measuring inconsistency in meta-analyses. BMJ. 2003;327(7414):557–60.
Westerterp KR. Alterations in energy balance with exercise. Am J Clin Nutr. 1998;68(4):970s–4s.
Spirduso WW, Cronin DL. Exercise dose-response effects on quality of life and independent living in older adults. Med Sci Sports Exerc. 2001;33(6 Suppl):S598–608 (discussion S9–10).
Paterson DH, Warburton DE. Physical activity and functional limitations in older adults: a systematic review related to Canada’s Physical Activity Guidelines. Int J Behav Nutr Phys Act. 2010;7:38.
Blaak EE, Westerterp KR, Bar-Or O, et al. Total energy expenditure and spontaneous activity in relation to training in obese boys. Am J Clin Nutr. 1992;55(4):777–82.
Eliakim A, Scheett T, Allmendinger N, et al. Training, muscle volume, and energy expenditure in nonobese American girls. J Appl Physiol (1985). 2001;90(1):35–44.
McLaughlin R, Malkova D, Nimmo MA. Spontaneous activity responses to exercise in males and females. Eur J Clin Nutr. 2006;60(9):1055–61.
Buman MP, Winkler EA, Kurka JM, et al. Reallocating time to sleep, sedentary behaviors, or active behaviors: associations with cardiovascular disease risk biomarkers, NHANES 2005–2006. Am J Epidemiol. 2014;179(3):323–34.
Hunter GR, Bickel CS, Fisher G, et al. Combined aerobic and strength training and energy expenditure in older women. Med Sci Sports Exerc. 2013;45(7):1386–93.
Kempen KP, Saris WH, Westerterp KR. Energy balance during an 8-wk energy-restricted diet with and without exercise in obese women. Am J Clin Nutr. 1995;62(4):722–9.
Redman LM, Heilbronn LK, Martin CK, et al. Metabolic and behavioral compensations in response to caloric restriction: implications for the maintenance of weight loss. PLoS One. 2009;4(2):e4377.
Stubbs RJ, Hughes DA, Johnstone AM, et al. Rate and extent of compensatory changes in energy intake and expenditure in response to altered exercise and diet composition in humans. Am J Physiol Regul Integr Comp Physiol. 2004;286(2):R350–8.
Drenowatz C, Grieve GL, DeMello MM. Change in energy expenditure and physical activity in response to aerobic and resistance exercise programs. Springerplus. 2015;4:798.
Wasenius N, Venojarvi M, Manderoos S, et al. The effect of structured exercise intervention on intensity and volume of total physical activity. J Sports Sci Med. 2014;13(4):829–35.
Wasenius N, Venojarvi M, Manderoos S, et al. Unfavorable influence of structured exercise program on total leisure-time physical activity. Scand J Med Sci Sports. 2014;24(2):404–13.
Kirk EP, Donnelly JE, Smith BK, et al. Minimal resistance training improves daily energy expenditure and fat oxidation. Med Sci Sports Exerc. 2009;41(5):1122–9.
Smith GD. A fatter, healthier but more unequal world. Lancet. 2016;387(10026):1349–50.
Beaulieu K, Hopkins M, Blundell J, et al. Does habitual physical activity increase the sensitivity of the appetite control system? a systematic review. Sports Med. 2016;46:1897–1919.
Whiting P, Westwood M, Burke M, et al. Systematic reviews of test accuracy should search a range of databases to identify primary studies. J Clin Epidemiol. 2008;61(4):357–64.
Papaioannou D, Sutton A, Carroll C, et al. Literature searching for social science systematic reviews: consideration of a range of search techniques. Health Info Libr J. 2010;27(2):114–22.
Linder SK, Kamath GR, Pratt GF, et al. Citation searches are more sensitive than keyword searches to identify studies using specific measurement instruments. J Clin Epidemiol. 2015;68(4):412–7.
Rosenberg M. The file-drawer problem revisited: a general weighted method for calculating fail-safe numbers in meta-analysis. Evolution. 2005;59(2):464–8.
Corder K, Brage S, Ekelund U. Accelerometers and pedometers: methodology and clinical application. Curr Opin Clin Nutr Metab Care. 2007;10(5):597–603.
Stewart LA, Tierney JF. To IPD or not to IPD? Advantages and disadvantages of systematic reviews using individual patient data. Eval Health Prof. 2002;25(1):76–97.
No sources of funding were used to assist in the preparation of this article.
Conflict of interest
Michael Fedewa, Elizabeth Hathaway, Tyler Williams, and Michael Schmidt have no conflicts of interest relevant to the content of this review.
Michael Fedewa conceptualized and designed the study, coded and analyzed effects, carried out the initial analysis, drafted the initial manuscript, and approved the final manuscript as submitted. Elizabeth Hathaway coded and analyzed effects, reviewed and revised the initial manuscript, and approved the final manuscript as submitted. Tyler Williams coded and analyzed effects, reviewed and revised the initial manuscript, and approved the final manuscript as submitted. Michael Schmidt reviewed and revised the initial manuscript and approved the final manuscript as submitted.
Electronic supplementary material
Below is the link to the electronic supplementary material.
About this article
Cite this article
Fedewa, M.V., Hathaway, E.D., Williams, T.D. et al. Effect of Exercise Training on Non-Exercise Physical Activity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Sports Med 47, 1171–1182 (2017). https://doi.org/10.1007/s40279-016-0649-z
- Exercise Training
- Resistance Training
- Compensatory Change
- Exercise Training Program
- Electronic Database Search