Long-term change in body composition following intentional weight loss and its effect on physical function

Area of Science:

• Gerontology
• Metabolic Diseases
• Exercise Physiology

Background:

• Intentional weight loss in older adults with obesity and type 2 diabetes mellitus (T2DM) raises concerns about lean mass reduction and subsequent physical function decline.
• Long-term associations between body composition changes and physical function after weight loss interventions remain unclear.

Purpose of the Study:

• To examine the long-term association between changes in body composition and physical function 8 years after an intensive lifestyle intervention (ILI) in middle-aged and older adults with T2DM.
• To assess the impact of intentional weight loss on body composition and physical function over an 8-year period.

Main Methods:

• Secondary analysis of 220 participants from the Baton Rouge site of the Look AHEAD study.
• Participants with overweight/obesity and T2DM were randomized to an intensive lifestyle intervention (ILI) or diabetes support and education (DSE).
• Body composition was measured using dual-energy X-ray absorptiometry; physical performance and strength were assessed at baseline and 8-year follow-up.

Main Results:

• Over 8 years, the ILI group showed greater reductions in weight and lean mass compared to DSE, but maintained better physical performance (SPPBexp) and gait speed.
• Increases in fat mass were linked to poorer physical performance and slower gait speed.
• Decreases in lean mass were associated with reduced grip and knee extensor strength.

Conclusions:

• While the ILI demonstrated positive effects on physical function, body composition changes are critical.
• Increased fat mass correlated with diminished physical performance, and lean mass loss was linked to decreased strength.
• Strategies should focus on preserving lean mass and managing fat mass during weight loss interventions for long-term health benefits.