BACKGROUND:
Obesity exacerbates the age-related decline in physical function and causes frailty in older persons. However, appropriate treatment for
obese older persons is unknown. We evaluated the effects of weight loss and
exercise therapy on physical function and
body composition in
obese older persons. METHODS: We screened 40
obese older volunteers and eventually
randomized 27 frail
obese older volunteers to treatment or
control groups. Treatment consisted of 6 months of weekly behavioral therapy for weight loss in conjunction with
exercise training 3 times per week. Physical function was evaluated with measurements of frailty (Physical Performance Test, peak
oxygen consumption, and Functional Status Questionnaire);
strength,
gait, and
balance tests;
body composition with
dual-energy x-ray absorptiometry; and quality of life using the Medical Outcomes Survey 36-Item Short-Form Health Survey. Results are reported as
mean +/- SD. RESULTS: Two subjects in the treatment group did not comply with the intervention, and 1 subject in the
control group withdrew. Analyses included all 27 subjects originally
randomized to the treatment and
control groups. The treatment group lost 8.4% +/- 5.6% of body weight, whereas weight did not change in the
control group (+0.5% +/- 2.8%;
P<.001). Compared with the
control group,
fat mass decreased (-6.6 +/- 3.4 vs +1.7 +/- 4.1 kg;
P<.001), without a change in
fat-free
mass (-1.2 +/- 2.1 vs -1.0 +/- 3.5 kg;
P = .75) in the treatment group. The Physical Performance Test score (2.6 +/- 2.5 vs 0.1 +/- 1.0;
P = .001), peak
oxygen consumption (1.7 +/- 1.6 vs 0.3 +/- 1.1
mL/min per
kilogram;
P = .02), and Functional Status Questionnaire score (2.9 +/- 3.7 vs -0.2 +/- 3.9;
P = .02) improved in treated subjects compared with
control subjects. Treatment also improved
strength, walking speed, obstacle course, 1-leg
limb stance time, and health survey physical subscale scores (all
P<.05). CONCLUSION: These findings suggest that weight loss and
exercise can ameliorate frailty in
obese older adults.Trial Registration clinicaltrials.gov Identifier: NCT00146133.