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ContextPhysical inactivity contributes to weight gain, but only 22% of Americans are regularly active.ObjectiveTo examine short- and long-term changes in weight, body composition, and cardiovascular risk profiles produced by diet combined with either structured aerobic exercise or moderate-intensity lifestyle activity.DesignSixteen-week randomized controlled trial with 1-year follow-up, conducted from August 1995 to December 1996.Participants and SettingForty obese women (mean body mass index [weight in kilograms divided by the square of height in meters], 32.9 kg/m2; mean weight, 89.2 kg) with a mean age of 42.9 years (range, 21-60 years) seen in a university-based weight management program.InterventionsStructured aerobic exercise or moderate lifestyle activity; low-fat diet of about 1200 kcal/d.Main Outcome MeasuresChanges in body weight, body composition, cardiovascular risk profiles, and …