Resistance training during a 12-week protein supplemented VLCD treatment enhances weight-loss outcomes in obese patients
Abstract
Background This investigation evaluated the efficacy by which resistance training enhances body composition, metabolic, and functional outcomes for obese patients undergoing a 12-week medically supervised hypocaloric treatment. Methods This was a single-blind, randomized, parallel-group prospective trial. Morbidly obese patients were prescribed a 12-week proprietary very low calorie diet (VLCD) treatment (Optifast®) with supplemental protein (1120 kcals/day) and were placed in one of two groups for 14 weeks: 1) Standard Treatment Control (CON) (n = 5) or 2) Resistance Training (RT) (n = 6). Both groups underwent a pedometer-based walking program; however only RT performed resistance training 3 days/week for 12 weeks. Body composition, resting energy expenditure (REE), neuromuscular function, and serum biomarkers were measured at weeks 0, 6, and 13. Results Both groups exhibited a significant loss of total body mass (TBM) (CON: -19.4 ± 2.3 kg, p = 0.0009 vs. RT: -15.8 ± 1.5 kg, p = 0.0002) and fat mass (FM) (CON: -14.7 ± 1.8 kg, p = 0.0002 vs. RT: -15.1 ± 2.1 kg, p = 0.0002) with no group differences. CON lost 4.6 ± 0.8 kg (p = 0.004) of lean mass (LM) while RT demonstrated no changes. Group differences were found for the relative proportion of total weight-loss due to FM-loss (CON: 75.6 ± 3.4% vs. RT: 96.0 ± 6.0%, p = 0.03) and LM-loss (CON: 24.4 ± 3.2% vs. RT: 4.0 ± 6.5%, p = 0.03). CON demonstrated a 328.6 ± 72.7 kcal/day (-14.3 ± 2.4%) (p = 0.02) decrease in REE while RT exhibited a non-significant decrease of 4.6 ± 1.6% (p = 0.78). RT demonstrated greater improvements in all measures of contractile function and strength when compared to CON (p < 0.05). At post-treatment, RT exhibited greater serum free fatty acids (p = 0.01), glycerol (p = 0.003), and β-hydroxybutyrate (p = 0.005) than CON. Conclusion Resistance training was advantageous for weight-loss composition by preservation of LM without compromising overall weight- or fat-loss in morbidly obese men and women undergoing a protein supplemented VLCD. These changes accompanied positive adaptations for resting metabolism and muscular function.
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Exercise combined with a weight loss program provides only modest outcomes for offsetting lean body mass loss, likely due to modest caloric expenditure with moderate exercise.
“In an effort to offset this LBM loss, several studies have incorporated exercise in conjunction with a weight loss program; however, this has only provided modest outcomes, most likely due to the modest caloric expenditure experienced with moderate exercise [7].”
From Body Composition Changes in Weight Loss: Strategies and Supplementation for Maintaining Lean Body Mass, a Brief Review (2018) · cites this paper as [7]
A recent study using a popular very low-calorie diet system supplemented with whey protein described a total body weight loss of 17 kg, of which 4.6 kg was lean body mass (approximately 25% of weight lost), after twelve weeks of a 1120 kcal/day, high protein, low-fat diet.
“A recent study using a popular VLCD system (Optifast®, Nestlé HealthCare Nutrition, Bridgewater, NJ, USA) supplemented with whey protein described a total body weight loss of 17 kg, of which 4.6 kg was LBM (approximately 25% of the weight lost), after twelve weeks of following this 1120 kcal/day, high protein, low-fat diet [7].”
From Body Composition Changes in Weight Loss: Strategies and Supplementation for Maintaining Lean Body Mass, a Brief Review (2018) · cites this paper as [7]
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“6 kg was LBM (approximately 25% of the weight lost), after twelve weeks of following this 1120 kcal/day, high protein, low-fat diet [7].”
BackgroundEglseer, D., Traxler, M., Embacher, S., Reiter, L., Schoufour, J. D., Weijs, P. J. M., Voortman, T., Boirie, Y., Cruz-Jentoft, A., & Bauer, S. (2023) · Advances in Nutrition · doi:10.1016/j.advnut.2023.04.001 · Cited by 102 · see citing works
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- Authors
- Jo, E., Worts, P. R., Elam, M. L., Brown, A. F., Khamoui, A. V., Kim, D.-H., Yeh, M.-C., Ormsbee, M. J., Prado, C. M., Cain, A., Snyder, K., & Kim, J.-S.
- Affiliations
- California State Polytechnic University (US)
- Florida State University (US)
- University of Idaho (US)
- Florida Atlantic University (US)
- University of Alberta (CA)
- Tallahassee Memorial HealthCare (US)
- Corresponding author
- Kim, Jeong-Su
- ORCID
- Venue
- Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2019-02
- Volume
- 38
- Issue
- 1
- Pages
- 372-382
- ISSN
- 0261-5614 (ISSN-L)
- OpenAlex
- W2781276735
- Cited by
- 28
- References
- 5
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 4 · 2023: 3 · 2022: 5 · 2021: 4 · 2020: 2 · 2019: 1 · 2018: 1
- FWCI
- 0.81
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Strength and Conditioning Association Foundation
- Topics
- Health Sciences › Medicine › Physiology › Diet and metabolism studies
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Physiology › Dietary Effects on Health
- Keywords
- resistance training, very low calorie diet, obesity, weight loss, protein supplementation, body composition, fat loss, lean body mass, resting energy expenditure, neuromuscular function, muscle strength, free fatty acids, glycerol, serum biomarkers, hypocaloric diet, contractile function, functional capacity
- MeSH terms
- Diet, Reducing, Dietary Proteins, Female, Humans, Male, Middle Aged, Obesity, Morbid, Prospective Studies, Therapeutics, Weight Loss, Single-Blind Method, Dietary Supplements, Resistance Training
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