title: Impact on weight and physical function of intensive medical weight loss in older adults with stage II and III obesity.
abstract: A 6-month pilot trial compared two strategies for weight loss in older adults with body mass indexes (BMIs) ≥35 kg/m(2) to assess weight loss response, safety, and impact on physical function.
  
  
  
  Twenty-eight volunteers were randomized to a balanced deficit diet (BDD) (500 kcal/day below estimated energy needs) or an intensive, low-calorie, meal replacement diet (ILCD, 960 kcal/day). Behavioral interventions and physical activity prescriptions were similar for both groups. Primary outcomes were changes in body weight and adverse event frequency; secondary outcomes included measures of physical function and body composition.
  
  
  
  ILCD average weight change was -19.1 ± 2.2 kg or 15.9 ± 4.6% of initial body weight compared with -9.1 ± 2.7 kg or 7.2 ± 1.9% for BDD. ILCD lost more fat mass (-7.7 kg, 95% CI [-11.9 to -3.5]) but had similar loss of lean mass (-1.7 kg, 95% CI [-4.1 to 0.6]) compared with BDD. There were no significant differences in change in physical function or adverse event frequency.
  
  
  
  Compared with a traditional BDD intervention, older adults who have severe obesity treated with intensive medical weight loss had greater weight loss and decreases in fat mass without a higher frequency of adverse events. In the short term, however, this did not translate into greater improvements in physical function.
authors.affiliation: Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston Salem, North Carolina, USA.|Department of Surgery, Weight Management Center, Wake Forest School of Medicine, Winston Salem, North Carolina, USA.
authors.forename: Jamy D
authors.initials: JD
authors.lastname: Ard
authors.affiliation: Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston Salem, North Carolina, USA.
authors.forename: Miranda
authors.initials: M
authors.lastname: Cook
authors.affiliation: Department of Biostatistics, Wake Forest School of Medicine, Winston Salem, North Carolina, USA.
authors.forename: Julia
authors.initials: J
authors.lastname: Rushing
authors.affiliation: Department of Surgery, Weight Management Center, Wake Forest School of Medicine, Winston Salem, North Carolina, USA.
authors.forename: Annette
authors.initials: A
authors.lastname: Frain
authors.affiliation: Department of Geriatrics, Wake Forest School of Medicine, Winston Salem, North Carolina, USA.
authors.forename: Kristen
authors.initials: K
authors.lastname: Beavers
authors.affiliation: Department of Health and Exercise Science, Wake Forest University, Winston Salem, North Carolina, USA.
authors.forename: Gary
authors.initials: G
authors.lastname: Miller
authors.affiliation: Department of Biostatistics, Wake Forest School of Medicine, Winston Salem, North Carolina, USA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Miller
authors.affiliation: Department of Geriatrics, Wake Forest School of Medicine, Winston Salem, North Carolina, USA.
authors.forename: Barb
authors.initials: B
authors.lastname: Nicklas
mesh_terms: D000368:Aged; D001521:Behavior Therapy; D001823:Body Composition; D015992:Body Mass Index; D031204:Caloric Restriction; D004038:Diet, Reducing; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000150:complications / Q000503:physiopathology* / Q000628:therapy*; D009767:Obesity, Morbid / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology*