Over 2 years we observed and investigated 26 patients (5 men and 13 women) aged 21 to 69 who gained weight when they began to engage in physical activity. They weighed 62 to 144 kg. These patients achieved an exercise calorimetry and segmental impedance and we compared to 15 matched subjects (2 men and 13 women) who gradually lose weight with a protocol of physical activity at low to moderate intensity.
There are no differences in body composition. Exercise calorimetry evidences that the ability of these subjects to oxidize lipid was both significantly lower (8.10 ± 0.49 vs 10.8 ± 1.04 mg/min/kg of muscle, P < 0.02) and shifted towards a lower power intensity (36.43 ± 2.64 vs 47.16 ± 4.77 watts, P = 0.05). The level where there is no longer lipid oxidation and an exclusive use of carbohydrates also occurs in these subjects at a lower intensity (61.7 ± 3.1% vs 75.18 ± 5.90% VO2max, P < 0.05). All these patients that gain weight during exercise training perform low volumes (2–3 h/wk) of exercise that are clearly targeted above the lipid oxidation zone. These subjects describe feelings of increased hunger after exercise, with or without binging and nibbling. When exercise is performed immersed in water it also appears to stimulate appetite and to result in weight gain in some individuals.
Therefore, paradoxical weight gain due to low volume of exercise at > 60% VO2max is not uncommon, although it seems a priori illogical and is thus largely ignored. It seems to be primarily determined by a targeting above the area of lipid oxidation, resulting into orexigenic falls in blood glucose, mostly in subjects that are low fat oxidizers. The glucose lowering effect of exercise performed in water may also favor this mechanism.