Background: To validate the traditional talk test (TTT) and an alternative talk test (ATT; using a visual analog scale) in overweight/obese (OW-OB) patients and to establish its accuracy in determining the aerobic training zones. 

Methods: We recruited 19 subjects aged 34.9 ± 6.7 years, diagnosed with overweight/obesity (BMI 31.8 ± 5.7). Every subject underwent incremental cycloergometric tests for maximal oxygen consumption, and TTT in a randomized order. At the end of each stage during the TTT, each subject read out loud a 40 words text and then had to identify the comfort to talk in two modalities: TTT which consisted in answering “Yes,” “I don’t know,” or “No” to the question Was talking comfortable?, or ATT through a 1 to 10 numeric perception scale (visual analog scale (VAS)). The magnitude of differences was interpreted in comparison to the smallest worthwhile change and was used to determine agreement. 

Results: There was an agreement between the power output at the VAS 2–3 of ATT and the power output at the ventilatory threshold 1 (VT1) (very likely equivalent; mean difference − 1.3 W, 90% confidence limit (CL) (− 8.2; 5.6), percent chances for higher/similar/lower values of 0.7/99.1/0.2%). Also, there was an agreement between the power output at the VAS 6–7 of ATT and the power output at the ventilatory threshold 2 (VT2) (very likely equivalent; mean difference 11.1 W, 90% CL (2.8; 19.2), percent chances for higher/similar/lower values of 0.0/97.6/2.4%). 

Conclusions: ATT is a tool to determine exercise intensity and to establish aerobic training zones for exercise prescription in OW-OB patients.