Comparison of Supervised and Unsupervised Physical Activity Programs During a Weight Loss Intervention for Adults
Comparison of Supervised and Unsupervised Physical Activity Programs During a Weight Loss Intervention for Adults
Adults who are overweight or obese are typically prescribed a calorie-restricted diet and
 physical activity to promote weight loss and improve health. The manner in which physical
 activity is prescribed and monitored may influence physical activity engagement. Within the
 context of clinical research, physical activity has been prescribed in either a supervised or
 unsupervised manner. Supervised physical activity is typically done in a health-fitness
 facility under the direct supervision of trained staff. The alternative, unsupervised
 physical activity, promotes physical activity participation in a setting that is convenient
 to the individual. Unsupervised activity can be done in any environment or at any time that
 best suits the individual. Knowing the effects of unsupervised physical activity is important
 because of the translation of this type of physical activity to non-research settings.
 Therefore, knowing the magnitude of the physiological effects of unsupervised physical
 activity compared to supervised physical activity at the same prescribed intensity and dose
 is of clinical and public health importance. This study is designed to provide insight on
 these important research questions that can inform future research and the application to
 clinical, public health, and health-fitness settings.
Approximately 69% of the U.S. adult population is overweight, defined by a body mass index
 (BMI) of ≥ 25.0 kg/m2, and 35% are obese (BMI ≥ 30.0 kg/m2), with the prevalence of
 overweight and obesity rising drastically over the past several decades. Adults who are
 overweight or obese are typically recommended to change lifestyle factors (e.g. diet,
 physical activity, etc.) to lose weight and improve health. When evaluating the effects of
 these lifestyle changes on weight and health in a research setting, physical activity is
 supervised (i.e. physical activity completed in a health-fitness facility with direct
 supervision from trained staff). With supervised physical activity, researchers are able to
 quantify the frequency, intensity, duration, and type of physical activity. Thus, supervised
 physical activity is considered the gold-standard when evaluating the effects of physical
 activity on weight and other physiological parameters. However, the results of supervised
 physical activity trials may not translate to clinical settings. A typical clinical approach
 prescribes physical activity in an unsupervised manner (i.e. physician tells patient to be
 more physically active or take more steps/day). Unsupervised physical activity can be done in
 any environment or at any time that best suits the individual. Knowing the effects of
 unsupervised physical activity is important because of the translation of this type of
 physical activity to non-research settings. Therefore, knowing the magnitude of the
 physiological effects of unsupervised physical activity compared to supervised physical
 activity at the same prescribed intensity and dose is of clinical and public health
 importance especially in an overweight and obese population. This study is designed to
 provide insight on these important research questions that can inform future research and the
 application to clinical, public health, and health-fitness settings.

 Participants will be randomized to one of three groups: supervised physical activity
 prescribed in min/week (SUP-PA), unsupervised physical activity prescribed in min/week
 (UNSUP-PA), and unsupervised physical activity prescribed in steps/day (STEP). Participants
 in all three groups will participate in a behavioral weight loss intervention which includes
 dietary counseling and weekly group sessions during the 12-week program. SUP-PA will be
 prescribed 150 minutes/week of moderate-to-vigorous physical activity (MVPA) completed under
 direct supervision of trained staff at a designated health-fitness facility. UNSUP-PA will be
 prescribed a physical activity dose matched to SUP-PA. STEP will be prescribed a 10,000
 step/day recommendation with 2,500 of those steps completed at a "brisk" pace. The primary
 aim of this study is to compare the effects of all three groups on moderate-to-vigorous
 physical activity (MVPA) accumulated in bouts of at least 10 minutes. The primary outcome
 will be assessed at baseline, week 4, week 8, and week 12. Secondary aims of this trial
 include comparing light intensity physical activity, sedentary time, cardiorespiratory
 fitness, weight, body composition, waist circumference measures, physical activity
 self-efficacy, blood pressure, and dietary intake across all three groups. Secondary aims
 will be assessed at baseline and week 12.
Inclusion Criteria:

 -  Male or Female

 -  Aged 18-55 years old

 -  BMI of 25.0 to <40.0 kg/m2

 -  Ability to provide informed consent

 -  Ability to provide physician's clearance to participate in a weight loss intervention

 Exclusion Criteria:

 -  Engaging in >60 min/wk (accumulated in bouts of ≥10 minutes) of moderate-to-vigorous
 physical activity over the past month

 -  Presence of contraindications to physical activity as identified on a physical
 activity readiness questionnaire (PAR-Q)

 -  History of metabolic, cardiac, or pulmonary disease that classifies the individual as
 high risk by the American College of Sports Medicine (e.g., coronary heart disease,
 diabetes mellitus, uncontrolled hypertension, etc.)

 -  History of myocardial infarction, coronary bypass surgery, angioplasty, or other
 cardiovascular- related surgeries.

 -  Taking medication that may affect heart rate or blood pressure responses to physical
 activity

 -  Resting systolic blood pressure ≥150mmHg or diastolic blood pressure ≥100mmHg.

 -  Medication that may affect body weight/metabolism (e.g., synthroid).

 -  Current or previous participation in a physical activity or weight management research
 project in the past 6 months

 -  Weight loss of ≥5% or 15 pounds total of current body weight in the previous 6 months.

 -  Currently being treated for an eating disorder (e.g., anorexia, bulimia, etc.)

 -  Previously undergone bariatric surgery (e.g., lap-band, gastric bypass, etc.)

 -  For women, those currently pregnant, pregnant during the previous 6 months, or plan on
 becoming pregnant in the next 6 months

 -  Currently being treated for any psychological issues or problems, taking any
 psychotropic medications, or receiving treatment with psychotropic medications within
 the previous 6 months.

 -  Being out of town during for an extended amount of time during the weight loss
 intervention which may affect participation in the study

 -  Currently using a physical activity monitor to track activity (e.g., Jawbone UP,
 Fitbit, etc.)