Using Multiple Tactics to Achieve Weight Loss

Excess weight has been linked to a wide range of undesirable health conditions, including hypertension, high cholesterol and prediabetes, which might become type 2 diabetes. Doctors frequently exhort their heavy patients to lose weight, but they may not know which approaches to recommend. A new study shows that some people need to use multiple tactics to achieve weight loss.

What Are the Best Tactics to Achieve Weight Loss?

Researchers at the University of Alabama conducted the Adaptive Dietary and exercise strategies for weight loss in Adults with Prediabetes Trial (ADAPT) to learn whether some are better than others (American Journal of Clinical Nutrition, Oct. 2025). They recruited 83 people with prediabetes and excess weight to the four-month trial.

How Did They Begin?

The investigators randomized the volunteers into one of two groups to start. One group followed a reduced carbohydrate diet; the other had a high-carbohydrate menu. Calories for both groups were limited to achieve weight loss. This phase lasted four weeks.

During that first month, about half the participants did not lose at least 2.5% of their body weight. The scientists once again randomized them for two different additional approaches. One group adopted time-restricted eating, while the other increased their exercise. All the study subjects continued with their assigned low-calorie meal plans.

What Were the Results?

The researchers were not surprised that so many of their volunteers did not meet their weight loss goal in the first month. After all, losing weight is hard. The group assigned to time-restricted eating were told to start their meals no later than 9 am and complete them within 8 hours. Outside of the permissible time frame, they were to consume nothing but water or non-caloric beverages.

Volunteers who were assigned to exercise met with exercise coaches weekly so that they would complete 150 minutes or more weekly of moderate to vigorous physical activity. Most people chose walking, but some did strength training, yoga or Pilates instead.

After 16 weeks, there were no apparent differences in weight loss between the reduced-carb and high-carb groups. Both groups lost roughly 12 pounds. Those who added exercise or time-restricted eating to their tactics to achieve weight loss managed around 8 pounds in total. (Remember, these were the folks who got off to a slow start.)

There are hints of differences in the success of these strategies, though. The investigators suggest that people on the reduced carbohydrate regimen did better when they added exercise, whereas those on a higher-carb (but still low-calorie) diet saw more success with time-restricted eating.

The Take-Home on Tactics to Achieve Weight Loss:

The researchers were disappointed that the second-stage tactics were not more effective for people who were having trouble losing weight.  They suggest that people struggling with prediabetes and obesity may need more intensive and costly intervention strategies. Those who are designing their own weight loss plans may want to add both exercise and time-restricted eating to their low-calorie meal patterns. They might also want to listen to our interviews with Dr. David Kessler and Dr. Herman Pontzer. They are found in Show 1449.