Heterogeneity in Treatment Outcomes After a Multicomponent Weight Loss Intervention in Older Adults with Obesity

Older adults age 65+ with obesity are a growing population with marked clinical complexity, which is exacerbated by comorbid conditions as they age.

To assess clinical heterogeneity in participants in a weight loss intervention to help understanding treatment outcomes.

We previously conducted a single-arm, pre/post, 24-wk, telemedicine-delivered diet and exercise intervention in older adults with obesity. Heterogeneity in treatment outcomes was evaluated between baseline and follow-up weight, 30-s sit-to-stand (30STS), 6-min walking test (6MWT), oxygen consumption at rest (resting VO₂), and total energy expenditure (TEE). Distributions of differences in physical function before and after the weight loss intervention were evaluated based on participants' weight loss response status.

Of the 53 enrolled participants, 44 completed the study, but 31 had full follow-up measures. The mean ± standard deviation age was 72.9 ± 3.9 y (72.7% female). Across all participants, weight decreased from 97.8 ± 16.3 kg to 93.2 ± 15.8 kg, and BMI (in kg/m²) dropped from 36.5 ± 5.2 to 34.7 ± 5.4. Twenty-two individuals were classified as responders to the weight loss intervention, having achieved >5% weight loss. Both groups exhibited significant improvements in physical function, though the magnitude of differences was nonsignificant, other than 6MWT (P = 0.04) at 24-wk. There was variability observed in correlation coefficients (r) between percent weight loss and 30STS (r = ‒0.23), 6MWT (r = ‒0.10), resting VO₂ (r = ‒0.16), and TEE (r = 0.058). The coefficient of variation for changes from baseline in physical function measures demonstrated marked variability: 134%, 299%, 260%, and 2310% for 30STS, 6MWT, resting VO₂, and TEE, respectively.

Although older adults can improve outcomes in weight, body mass, and waist circumference through diet and physical activity interventions, there was marked heterogeneity observed in physical function outcomes.