The aim of this work was to study the long-term effects of the addition of exercise to a short-term diet in overweight postmenopausal women. A follow up study was made of 118 overweight, postmenopausal women, who 6 months earlier had completed 12 weeks of randomized intervention (three groups: 4.2 MJ/d diet, 4.2 MJ/d diet with exercise, and controls). The following were measured: body composition and fat distribution (measured by dual-energy X-ray absorptiometry), resting metabolic rate, serum lipids and lipoproteins, blood pressure, and bone mineral densities. It was found that weight was still significantly reduced (by about 8 kg). HDL-C was significantly increased (10%), and triglycerides decreased (20%), whereas the initial reductions in total cholesterol and LDL-C had disappeared at the follow-up. The women from the former diet-plus-exercise group, who were current exercisers at the follow-up, had a significantly greater reduction in weight (10.9 vs 6.6 kg), fat tissue mass (10.0 vs 5.4 kg) and abdominal-to-total-body fat tissue mass (9.6 vs 4.7), and a significantly greater increase in the resting metabolic rate (11.1 vs 1.1 kJ/kg/d), as compared with the non-exercisers from this group. There were no major detrimental changes in total body, spinal, or forearm bone mineral density or in markers of bone turnover. The short-term dietary treatment in this study may have beneficial long-term effects on weight, fat tissue mass and cardiovascular risk factors with no additional benefits from added exercise, unless the exercise is continued.