The effects of lifestyle or programmed aerobic exercise, with or without a diet, on weight, fitness, and exercise adherence were assessed with 37 obese 8- to 12-year-old children over a 17-month period. The lifestyle program allowed the child to increase energy expenditure by engaging in a wide variety of daily games and activities, while the programmed aerobic alternative required the child to perform an aerobic exercise daily. The exercise programs differed in the flexibility of scheduling exercise, type of exercise, and intensity of exercise. Results showed equivalent weight and relative weight changes across all groups during the 8-week intensive treatment, with lifestyle subjects losing more additional weight and maintaining their weight loss better than the programmed exercise subjects during maintenance and follow-up. Fitness changes, as measured by heart rate during exercise and recovery, improved more during intensive treatment for the programmed than the lifestyle exercise groups. During maintenance, however, fitness of the programmed exercise group deteriorated, while fitness of the lifestyle group was maintained. The results suggest the utility of lifestyle exercise as a way to increase energy expenditure and long-term weight maintenance independent of diet.

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