Fat-free mass and resting metabolic rate are determinants of energy intake: implications for a theory of appetite control.

Any explanation of appetite control should contain a description of physiological processes that could contribute a drive to eat alongside those that inhibit eating. However, such an undertaking was largely neglected until 15 years ago when a series of independent research programmes investigated the physiological roles of body composition and appetite. These outcomes demonstrated that fat-free mass (FFM), but not fat mass, was positively associated with objectively measured meal size and energy intake (EI). These findings have been accompanied by demonstrations that resting metabolic rate (RMR) is also positively associated with EI, with the influence of FFM largely mediated by RMR. These findings re-introduce the role of drive into models of appetite control and indicate how this can be integrated with processes of inhibition. The determinants of EI fit into an evolutionary perspective in which the energy demands of high metabolic rate organs and skeletal tissue constitute a need state underlying a tonic drive to eat. This approach should lead to the development of integrated models of appetite that include components of body composition (FFM) and energy expenditure (RMR) as tonic biological signals of appetite alongside other traditional tonic (adipose tissue derived) and episodic signals (gastrointestinal tract derived). This article is part of a discussion meeting issue 'Causes of obesity: theories, conjectures and evidence (Part I)'.

The importance of fat-free mass and constituent tissue-organs in the control of human appetite.

PURPOSE OF REVIEW: Traditional models of human appetite focus on the contribution of adipose tissue and the gastrointestinal tract, both of which exert mainly inhibitory influences. The purpose of this review is to consider the biological factors that influence the drive to eat. RECENT FINDINGS: Fat-free mass is positively associated with objectively measured meal size and daily energy intake. These findings have been replicated in multiple populations across the life-course in laboratory and free-living studies. Studies have shown that the effect of fat-free mass is statistically mediated by resting metabolic rate, suggesting that energy expenditure per se may influence energy intake. A recent MRI study has reported that fasting hunger was associated with high metabolic rate organ (heart, liver, brain, kidneys) and skeletal muscle mass. Integrating measures of body composition at the tissue-organ level and markers of their metabolic function with appetitive measures could provide novel insight into the mechanisms that influence appetite. SUMMARY: These recent findings suggest that fat-free mass and resting metabolic rate are determinants of energy intake. Consideration of fat-free mass and energy expenditure as physiological sources of appetitive signals helps reconcile the mechanisms underpinning the inhibition of eating with those that drive eating.

Nuts, Energy Balance and Body Weight.

Over several decades, the health benefits of consuming nuts have been investigated, resulting in a large body of evidence that nuts can reduce the risk of chronic diseases. The consumption of nuts, being a higher-fat plant food, is restricted by some in order to minimize weight gain. In this review, we discuss several factors related to energy intake from nuts, including food matrix and its impact on digestibility, and the role of nuts in regulating appetite. We review the data from randomized controlled trials and observational studies conducted to examine the relationship between nut intake and body weight or body mass index. Consistently, the evidence from RCTs and observational cohorts indicates that higher nut consumption does not cause greater weight gain; rather, nuts may be beneficial for weight control and prevention of long-term weight gain. Multiple mechanisms likely contribute to these findings, including aspects of nut composition which affect nutrient and energy availability as well as satiety signaling.

The complex pattern of the effects of prolonged frequent exercise on appetite control, and implications for obesity.

From a public health perspective, much of the interest in the relationship between exercise and appetite rests on the implications for energy balance and obesity. Energy balance reflects a dynamic 2-way interaction between energy expenditure (EE) and energy intake (EI). Physical activity and exercise, and appetite are the behavioural components of EE and EI, respectively. Beyond EE, exercise is a powerful and complex physiological stimulus acting on several bodily systems. There are multiple effects of frequent and prolonged exercise on appetite which include inter alia an increase in fasting hunger, an enhancement of post-prandial satiety, a modulation of the hedonic responses to food and improvements in eating behaviour traits. These lead to variable adjustments in EI and in a reduction in the susceptibility to overconsumption. Frequent and prolonged physical activity and exercise behaviour can strengthen and sensitise the appetite control system, whilst physical inactivity and sedentariness (low level of EE) fails to downregulate EI and can permit overconsumption. Not all of the effects of exercise operate uniformly to drive appetite in the same direction. The complexity of the interaction between EE and EI means that the effects of prolonged exercise are characterised by substantial individual heterogeneity. This leads to variable effects on energy balance and body mass.

Validation of a Mobile App-Based Visual Analog Scale for Appetite Measurement in the Real World: A Randomized Digital Clinical Trial.

There has been no validated digital tool for measuring appetite with a visual analog scale (VAS) through a mobile app using participants' smart phones for data collection in virtual settings. To fill the gap, we developed a digital VAS and conducted a digital cross-over clinical trial by comparing appetite responses measured by this digital tool versus paper-based VAS in 102 participants in a free-living environment. Participants consumed either a 230 or 460 kcal breakfast in randomized order in two virtual sessions, and their appetite was measured over the next 4 h using both tools. The results revealed no significant difference in hunger, fullness, satiety, or desire to eat measured by digital and paper VAS. Paper VAS resulted in a higher prospective consumption score than digital VAS; the difference (1.1 out of 100 points) was statistically significant but not practically relevant. Bland and Altman analysis also indicated consistency in the results from the two methods. In conclusion, digital VAS on a smart phone is a validated tool for appetite measurement in the real world; it provides a new way for researchers to leverage participants' mobile devices for appetite data collection in digital trials.

Increases in physical activity are associated with a faster rate of weight loss during dietary energy restriction in women with overweight and obesity.

This secondary analysis examined the influence of changes in physical activity (PA), sedentary time and energy expenditure (EE) during dietary energy restriction on the rate of weight loss (WL) and 1-year follow-up weight change in women with overweight/obesity.Measurements of body weight and composition (air-displacement plethysmography), resting metabolic rate (indirect calorimetry), total daily (TDEE) and activity EE (AEE), minutes of PA and sedentary time (PA monitor) were taken at baseline, after 2 weeks, after ≥5% WL or 12 weeks of continuous (25% daily energy deficit) or intermittent (75% daily energy deficit alternated with ad libitum day) energy restriction, and at 1-year post-WL. The rate of WL was calculated as total %WL/number of dieting weeks. Data from both groups were combined for analyses.Thirty-seven participants (age=35±10y; BMI=29.1±2.3kg/m2) completed the intervention (WL=-5.9±1.6%) and 18 returned at 1-year post-WL (weight change=+4.5±5.2%). Changes in sedentary time at 2 weeks were associated with the rate of WL during energy restriction (r=-0.38; p=0.03). Changes in total (r=0.54; p<0.01), light (r=0.43; p=0.01) and moderate-to-vigorous PA (r=0.55; p<0.01), sedentary time (r=-0.52; p<0.01), steps per day (r=0.39; p=0.02), TDEE (r=0.46; p<0.01) and AEE (r=0.51; p<0.01) during energy restriction were associated with the rate of WL. Changes in total (r=-0.50; p=0.04) and moderate-to-vigorous PA (r=-0.61; p=0.01) between post-WL and follow-up were associated with 1-year weight change (r=-0.51; p=0.04).These findings highlight that PA and sedentary time could act as modifiable behavioural targets to promote better weight outcomes during dietary energy restriction and/or weight maintenance.

Associations between high-metabolic rate organ masses and fasting hunger: A study using whole-body magnetic resonance imaging in healthy males.

BACKGROUND: Fat-free mass (FFM) has been shown to be positively associated with hunger and energy intake, an association mediated by resting metabolic rate (RMR). However, FFM comprises a heterogeneous group of tissues with distinct metabolic rates, and it remains unknown how specific high-metabolic rate organs contribute to the degree of perceived hunger. OBJECTIVE: To examine whether FFM and its anatomical components were associated with fasting hunger when assessed at the tissue-organ level. DESIGN: Body composition (quantitative magnetic resonance and magnetic resonance imaging), RMR and whole-body glucose oxidation (indirect calorimetry), HOMA-index as a marker of insulin sensitivity, nitrogen balance and fasting hunger (visual analogue scales) were assessed in 21 healthy males (age = 25 ± 3y; BMI = 23.4 ± 2.1 kg/m2) after 3 days of controlled energy balance. RESULTS: FFM (rs = 0.39; p = 0.09), RMR (rs = 0.52; p = 0.02) and skeletal muscle mass (rs = 0.57; p = 0.04), but not fat mass (rs = -0.01; p = 0.99), were positively associated with fasting hunger. The association between the combined mass of high-metabolic rate organs (i.e., brain, liver, kidneys and heart; rs = 0.58; p = 0.006) and fasting hunger was stronger than with FFM as a uniform body component. The strongest individual association was between liver mass and fasting hunger (rs = 0.51; p = 0.02). No associations were observed between glucose parameters, markers of insulin sensitivity and fasting hunger. The encephalic measure, an index of brain-to-body energy allocation, was negatively associated with fasting hunger (rs = -0.51; p = 0.02). CONCLUSIONS: Fasting hunger was more strongly associated with the combined mass of high-metabolic rate organs than with FFM as a uniform body component, highlighting the importance of integrating individual tissue-organ masses and their functional correlates into homeostatic models of human appetite. The association between liver mass and fasting hunger may reflect its role in ensuring the brain's basal energy needs are met.

Fat-Free Mass and Total Daily Energy Expenditure Estimated Using Doubly Labeled Water Predict Energy Intake in a Large Sample of Community-Dwelling Older Adults.

BACKGROUND: Up to 30% of community-based older adults report reduced appetite and energy intake (EI), but previous research examining the underlying physiological mechanisms has focused on the mechanisms that suppress eating rather than the hunger drive and EI. OBJECTIVES: We examined the associations between fat-free mass (FFM), physical activity (PA), total daily energy expenditure (TDEE), and self-reported EI in older adults. METHODS: The present study was a secondary analysis of the Interactive Diet and Activity Tracking in AARP study. Body composition (deuterium dilution), PA (accelerometry), and TDEE (doubly labeled water) were measured in 590 older adults (age, 63.1 ± 5.9 years; BMI, 28.1 ± 4.9 kg/m2). The total daily EI was estimated from a single 24-hour dietary recall (EIsingle; ±1 month of PA and TDEE measurement) and the mean of up to 6 recalls over a 12-month period (EImean), with misreporters classified using the 95% CIs between the EImean and TDEE. RESULTS: After controlling for age and sex, linear regression demonstrated that FFM and TDEE predicted EI when estimated from a single 24-hour dietary recall (P < 0.05), from the mean of up to 6 dietary recalls (P < 0.05), and after the removal of those classified as underreporters (P < 0.001). Age moderated the associations between FFM and EIsingle (P < 0.001), FFM and EImean (P < 0.001), and TDEE with EIsingle (P = 0.016), with associations becoming weaker across age quintiles. CONCLUSIONS: These data suggest that the total daily EI is proportional to the FFM and TDEE, but not fat mass, in older adults. These associations may reflect an underling drive to eat that influences the daily food intake. While the associations between FFM or TDEE and EI existed across all age quintiles, these associations weakened with increasing age.

Fat-Free Mass and Total Daily Energy Expenditure Estimated Using Doubly Labeled Water Predict Energy Intake in a Large Sample of Community-Dwelling Older Adults.

BACKGROUND: Up to 30% of community-based older adults report reduced appetite and energy intake (EI), but previous research examining the underlying physiological mechanisms has focused on the mechanisms that suppress eating rather than the hunger drive and EI. OBJECTIVES: We examined the associations between fat-free mass (FFM), physical activity (PA), total daily energy expenditure (TDEE), and self-reported EI in older adults. METHODS: The present study was a secondary analysis of the Interactive Diet and Activity Tracking in AARP study. Body composition (deuterium dilution), PA (accelerometry), and TDEE (doubly labeled water) were measured in 590 older adults (age, 63.1 ± 5.9 years; BMI, 28.1 ± 4.9 kg/m2). The total daily EI was estimated from a single 24-hour dietary recall (EIsingle; ±1 month of PA and TDEE measurement) and the mean of up to 6 recalls over a 12-month period (EImean), with misreporters classified using the 95% CIs between the EImean and TDEE. RESULTS: After controlling for age and sex, linear regression demonstrated that FFM and TDEE predicted EI when estimated from a single 24-hour dietary recall (P < 0.05), from the mean of up to 6 dietary recalls (P < 0.05), and after the removal of those classified as underreporters (P < 0.001). Age moderated the associations between FFM and EIsingle (P < 0.001), FFM and EImean (P < 0.001), and TDEE with EIsingle (P = 0.016), with associations becoming weaker across age quintiles. CONCLUSIONS: These data suggest that the total daily EI is proportional to the FFM and TDEE, but not fat mass, in older adults. These associations may reflect an underling drive to eat that influences the daily food intake. While the associations between FFM or TDEE and EI existed across all age quintiles, these associations weakened with increasing age.

Free-Living Energy Balance Behaviors Are Associated With Greater Weight Loss During a Weight Loss Program.

Introduction: Free-living movement (physical activity [PA] and sedentary behavior [SB]) and eating behaviors (energy intake [EI] and food choice) affect energy balance and therefore have the potential to influence weight loss (WL). This study explored whether free-living movement and/or eating behaviors measured early (week 3) in a 14-week WL programme or their change during the intervention are associated with WL in women. Methods: In the study, 80 women (M ± SD age: 42.0 ± 12.4 years) with overweight or obesity [body mass index (BMI): 34.08 ± 3.62 kg/m2] completed a 14 week WL program focused primarily on diet (commercial or self-led). Body mass (BM) was measured at baseline, and again during week 2 and 14 along with body composition. Free-living movement (SenseWear Armband) and eating behavior (weighed food diaries) were measured for 1 week during week 3 and 12. Hierarchical multiple regression analyses examined whether early and early-late change in free-living movement and eating behavior were associated with WL. The differences in behavior between clinically significant weight losers (CWL; ≥5% WL) and non-clinically significant weight losers (NWL; ≤ 3% WL) were compared. Results: The energy density of food consumed [ß = 0.45, p < 0.001] and vigorous PA [ß = -0.30, p < 0.001] early in the intervention (regression model 1) and early-late change in light PA [ß = -0.81 p < 0.001], moderate PA [ß = -1.17 p < 0.001], vigorous PA [ß = -0.49, p < 0.001], total energy expenditure (EE) [ß = 1.84, p < 0.001], and energy density of food consumed [ß = 0.27, p = 0.01] (regression model 2) significantly predicted percentage change in BM. Early in the intervention, CWL consumed less energy dense foods than NWL [p = 0.03]. CWL showed a small but significant increase in vigorous PA, whereas NWL showed a slight decrease in PA [p = 0.04]. Conclusion: Both early and early-late change in free-living movement and eating behaviors during a 14 week WL program are predictors of WL. These findings demonstrate that specific behaviors that contribute to greater EE (e.g., vigorous PA) and lower EI (e.g., less energy-dense foods) are related to greater WL outcomes. Interventions targeting these behaviors can be expected to increase the effectiveness of WL programs.

Exercise training in the management of overweight and obesity in adults: Synthesis of the evidence and recommendations from the European Association for the Study of Obesity Physical Activity Working Group.

There is a need for updated practice recommendations on exercise in the management of overweight and obesity in adults. We summarize the evidence provided by a series of seven systematic literature reviews performed by a group of experts from across Europe. The following recommendations with highest strength (Grade A) were derived. For loss in body weight, total fat, visceral fat, intra-hepatic fat, and for improvement in blood pressure, an exercise training program based on aerobic exercise at moderate intensity is preferentially advised. Expected weight loss is however on average not more than 2 to 3 kg. For preservation of lean mass during weight loss, an exercise training program based on resistance training at moderate-to-high intensity is advised. For improvement in insulin sensitivity and for increasing cardiorespiratory fitness, any type of exercise training (aerobic, resistance, and combined aerobic or resistance) or high-intensity interval training (after thorough assessment of cardiovascular risk and under supervision) can be advised. For increasing muscular fitness, an exercise training program based preferentially on resistance training alone or combined with aerobic training is advised. Other recommendations deal with the beneficial effects of exercise training programs on energy intake and appetite control, bariatric surgery outcomes, and quality of life and psychological outcomes in management of overweight and obesity.

Effect of exercise training before and after bariatric surgery: A systematic review and meta-analysis.

We aimed to assess the effectiveness of exercise training programs in adults with severe obesity undergoing bariatric surgery. A systematic search of controlled trials published up to October 2019 that assigned participants to either a preoperative or postoperative exercise training group or a nonexercise group was performed. Meta-analyses were conducted using random-effects models. Twenty-two training programs were assessed (18 performed after bariatric surgery). The effect of preoperative exercise training on postsurgery outcomes was reported in only one study. Compared with the control condition without exercise, postoperative exercise training led to higher weight loss (N = 14, mean difference [95% CI] = -1.8 [-3.2; -0.4] kg, P = 0.01), fat loss (N = 9, P = 0.01), increase in VO2 max (N = 8, P < 0.0001), and increase in muscle strength (N = 9, P < 0.0001). No significant effect was found on lean body mass (N = 11). Preliminary evidence suggests a beneficial effect of postoperative exercise training on bone mineral density (N = 3, P < 0.001) and weight maintenance after the end of the intervention (N = 2, P < 0.001) but no significant effect on quality of life (N = 2), habitual physical activity (N = 2), or cardiometabolic outcomes (N < 4). In conclusion, exercise training performed after bariatric surgery improves physical fitness and leads to a small additional weight and fat loss and may prevent bone loss and weight regain after bariatric surgery.

Effects of oral lubrication on satiety, satiation and salivary biomarkers in model foods: A pilot study.

With a dramatic increase in overweight and population with obesity over the last decades, there is an imminent need to tackle this issue using novel strategies. Addressing obesity issues by generating satiety in food to reduce energy intake has been one of those prominent strategies and often textural interventions have been used to generate satiety, specifically in short-term trials. This study aimed to investigate the role of preloads varying in their oral lubricating properties on appetite sensations, food intake, salivary friction and concentration of salivary biomarkers (proteins, α-amylase and mucins) in collected human saliva (n = 17 healthy participants). The preloads were model foods (flavoured hydrogels) either high or low in their lubricating properties, assessed both by instrumental and sensorial measurements. The results showed that hunger and desire to eat decreased immediately after preload and remained decreased for 10 and 20 min, respectively, after preload in the high lubricating condition compared to control (all p < 0.05). Fullness increased immediately after preload and remained increased for 10 and 20 min, respectively, after preload in high lubricating condition compared to control (p < 0.05). However, after controlling the values for baseline, such significant effect of the intervention did not exist anymore. Only the effect of time is observed. Consuming high lubricating hydrogels showed no effect on food intake and salivary biomarkers in this pilot study. Salivary lubrication correlated with feeling of fullness. Considering the issue of large time-interval (30 min) between preload and next meal in this study, it is worthwhile investigating the immediate effects of oral lubrication on appetite control, food intake and salivary biomarkers.

Effect of exercise training on psychological outcomes in adults with overweight or obesity: A systematic review and meta-analysis.

This study systematically identified the effects of exercise on multiple psychological outcomes among adults with overweight/obesity, also assessing whether these effects differed across exercise types, genders, age, and body mass index (BMI) categories. Pubmed, Web of Science, PsychInfo, and SportDiscus were searched up to October 2019 for peer-reviewed papers assessing exercise training effects on psychosocial outcomes in adults with overweight/obesity. Thirty-six articles, 32 randomized controlled trials (RCTs), were included in this review. Most interventions were supervised (65%), ranging between 6 and 76 weeks (median = 12). Sixteen psychological outcomes were studied. Exercise induced positive changes in quality of life but did not reduce depression. Large effect sizes were observed on quality of life's physical component, but exercise was also able to improve vitality and mental health. Most psychological outcomes (e.g., body image, anxiety, and perceived stress) are poorly studied, evidencing either conflicting or null exercise effects. Exercise self-efficacy and autonomous motivations were also consistently improved. Exercise types and gender seem to moderate exercise psychological effects. Exercise training programs might lead to positive changes in some psychological outcomes, especially in quality of life, in adults with overweight and obesity, but more studies, with greater systematization in program characteristics, and longer follow-ups are still required to allow more solid conclusions.

Effect of exercise on cardiometabolic health of adults with overweight or obesity: Focus on blood pressure, insulin resistance, and intrahepatic fat-A systematic review and meta-analysis.

This systematic review examined the impact of exercise intervention programs on selected cardiometabolic health indicators in adults with overweight or obesity. Three electronic databases were explored for randomized controlled trials (RCTs) that included adults with overweight or obesity and provided exercise-training interventions. Effects on blood pressure, insulin resistance (homeostasis model of insulin resistance, HOMA-IR), and magnetic resonance measures of intrahepatic fat in exercise versus control groups were analyzed using random effects meta-analyses. Fifty-four articles matched inclusion criteria. Exercise training reduced systolic and diastolic blood pressure (mean difference, MD = -2.95 mmHg [95% CI -4.22, -1.68], p < 0.00001, I2  = 63% and MD = -1.93 mmHg [95% CI -2.73, -1.13], p < 0.00001, I2  = 54%, 60 and 58 study arms, respectively). Systolic and diastolic blood pressure decreased also when considering only subjects with hypertension. Exercise training significantly decreased HOMA-IR (standardized mean difference, SMD = -0.34 [-0.49, -0.18], p < 0.0001, I2 = 48%, 37 study arms), with higher effect size in subgroup of patients with type 2 diabetes (SMD = -0.50 [95% CI: -0.83, -0.17], p = 0.003, I2 = 39%). Intrahepatic fat decreased significantly after exercise interventions (SMD = -0.59 [95% CI: -0.78, -0.41], p < 0.00001, I2  = 0%), with a larger effect size after high-intensity interval training. In conclusion, exercise training is effective in improving cardiometabolic health in adults with overweight or obesity also when living with comorbitidies.

Effect of exercise training interventions on energy intake and appetite control in adults with overweight or obesity: A systematic review and meta-analysis.

This systematic review examined the impact of exercise training interventions on energy intake (EI) and appetite control in adults with overweight/obesity (≥18 years including older adults). Articles were searched up to October 2019. Changes in EI, fasting appetite sensations, and eating behavior traits were examined with random effects meta-analysis, and other outcomes were synthesized qualitatively. Forty-eight articles were included (median [range] BMI = 30.6 [27.0-38.4] kg/m2 ). Study quality was rated as poor, fair, and good in 39, seven, and two studies, respectively. Daily EI was assessed objectively (N = 4), by self-report (N = 22), with a combination of the two (N = 4) or calculated from doubly labeled water (N = 1). In studies rated fair/good, no significant changes in pre-post daily EI were found and a small but negligible (SMD < 0.20) postintervention difference when compared with no-exercise control groups was observed (five study arms; MD = 102 [1, 203] kcal). There were negligible-to-small pre-post increases in fasting hunger and dietary restraint, decrease in disinhibition, and some positive changes in satiety and food reward/preferences. Within the limitations imposed by the quality of the included studies, exercise training (median duration of 12 weeks) leads to a small increase in fasting hunger and a small change in average EI only in studies rated fair/good. Exercise training may also reduce the susceptibility to overconsumption (PROSPERO: CRD42019157823).

Effective behavior change techniques to promote physical activity in adults with overweight or obesity: A systematic review and meta-analysis.

Multicomponent behavior change interventions are typically used in weight management, but results are largely heterogeneous and modest. Determining which techniques (behavior change technique [BCTs]) are more effective in changing behavior is thus required. This study aimed to identify the most effective BCTs for increasing physical activity (PA) in digital and face-to-face behavior change interventions in adults with overweight/obesity. Four databases were searched for eligible studies until October 2019. BCTs were coded using BCTTv1 and MBCT taxonomies. Sixty-two RCTs were included. Meta-regressions were performed to explore BCTs' moderating role. Five BCTs showed significant moderator effects on PA in digital interventions: goal setting behavior, goal setting outcome, graded tasks, social incentive, and self-monitoring of behavior (adjusted R2 's = 0.15-0.51). One BCT showed significant moderator effects on PA in face-to-face interventions, behavioral practice and rehearsal (adjusted R2 = 0.22). Multivariate and sensitivity analysis generally led to similar findings. Effective BCTs for increasing PA in adults with overweight/obesity in digital and face-to-face interventions seem to differ. Evidence suggests that using goal setting, social incentive, and graded tasks might help improve PA in digital interventions while avoiding inconsistent self-monitoring of behavior. In face-to-face interventions, prompting behavioral practice and rehearsal might lead to better PA outcomes. Still, further studies are needed. Implications of the current findings are discussed.

Effect of exercise training on weight loss, body composition changes, and weight maintenance in adults with overweight or obesity: An overview of 12 systematic reviews and 149 studies.

This overview of reviews aimed to summarize the effects of exercise training programs on weight loss, changes in body composition, and weight maintenance in adults with overweight or obesity. A systematic search of systematic reviews and meta-analyses (SR-MAs) published between 2010 and December 2019 was performed. Only SR-MAs of controlled trials were included. The mean difference (MD) or standardized MD (SMD) were extracted from SR-MAs. Twelve SR-MAs (149 studies) were included. Exercise led to a significant weight loss (4 SR-MAs, MDs ranging from -1.5 to -3.5 kg), fat loss (4 SR-MAs, MDs ranging from -1.3 to -2.6 kg) and visceral fat loss (3 SR-MAs, SMDs ranging from -0.33 to -0.56). No difference in weight, fat, and visceral loss was found between aerobic and high-intensity interval training as long as energy expenditure was equal. Resistance training reduced lean mass loss during weight loss (1 SR-MA, MD: 0.8 [95%CI: 0.4-1.3] kg). No significant effect of exercise was found on weight maintenance (1 SR-MA). These findings show favorable effects of exercise training on weight loss and body composition changes in adults with overweight or obesity. Visceral fat loss may lead to benefits for cardiometabolic health. More research is needed to identify training modalities that promote weight maintenance.