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Cited by 15Nutrition and Health in AgingBody Composition Measurement TechniquesObesity, Physical Activity, Diet

Legacy effects of short-term intentional weight loss on total body and thigh composition in overweight and obese older adults

Open access
Chmelo, E A, Beavers, D P, Lyles, M F, Marsh, A P, Nicklas, B J, Beavers, K M·2016·Nutrition & Diabetes
DOI 10.1038/nutd.2016.8PMC PMC4855260
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Abstract

Objective: Weight regain following intentional weight loss may negatively impact body composition, accelerating fat regain and increasing risk of physical disability. The purpose of this study was to compare long-term changes in whole body and thigh composition in obese older adults who intentionally lost and then partially regained weight to obese older adults who remained weight stable. Subjects/Methods: This pilot study analyzed total body (dual-energy X-ray absorptiometry (DXA)) and thigh (computed tomography (CT)) composition data collected from 24 older (65–79 years) adults 18 months after completion of a 5-month randomized trial that compared resistance training alone (RT) with RT plus caloric restriction (RT+CR). Results: Mean loss of body mass in the RT+CR group (n=13) was 7.1±2.4 kg during the 5-month intervention (74% fat mass; 26% lean mass; all P<0.01), whereas RT (n=11) remained weight stable (+0.3±1.8 kg; P=0.64). Differential group effects were observed for all DXA and CT body composition measures at 5 months (all P⩽0.01); however, by 23 months, group differences persisted only for total body (RT+CR: 81.6±10.0 kg vs RT: 88.5±14.9 kg; P=0.03) and lean (RT+CR: 50.8±9.3 kg vs RT: 54.4±12.0 kg; P<0.01) mass. All RT+CR participants regained weight from 5 to 23 months (mean gain=+4.8±2.6 kg; P<0.01). Total fat mass and all thigh fat volumes increased, whereas thigh muscle volume decreased, during the postintervention follow-up in RT+CR (all P⩽0.01). In the RT group, body mass did not change from 5 to 23 months (−0.2±0.9 kg; P=0.87). Decreased total thigh volume, driven by the loss of thigh muscle volume, were the only postintervention body composition changes observed in the RT group (both P<0.04). Conclusions: Short-term body composition benefits of an RT+CR intervention may be lost within 18 months after completion of the intervention.

AI snapshot

Written from the paper’s full text.

TL;DR

In overweight and obese older adults, a 5-month resistance-training plus caloric-restriction (RT+CR) intervention produced clinically meaningful weight loss and favorable total-body and thigh composition changes, but these benefits were largely not sustained 18 months later. By 23 months, RT+CR participants had regained weight and fat—including nearly all lost thigh intermuscular fat—while continuing to lose thigh muscle volume.

Key findings

  • RT+CR participants (n=13) lost 7.1±2.4 kg during the 5-month intervention, with 74% of lost mass as fat and 26% as lean mass (all P<0.01); RT-only participants (n=11) remained weight stable (+0.3±1.8 kg; P=0.64).
  • At 23 months, group differences persisted only for total body mass (RT+CR: 81.6±10.0 kg vs RT: 88.5±14.9 kg; P=0.03) and lean mass (RT+CR: 50.8±9.3 kg vs RT: 54.4±12.0 kg; P<0.01); fat mass was no longer significantly different between groups.
  • All RT+CR participants regained weight from 5 to 23 months (mean +4.8±2.6 kg; range 0.4–9.1 kg; P<0.01), with increased total fat mass and all thigh fat volumes but decreased thigh muscle volume (all P≤0.01).
  • During follow-up, RT+CR regained ~82% of lost subcutaneous thigh fat (−94.7±16.7 cm³ from baseline to 5 months vs +78.1±18.5 cm³ from 5 to 23 months) and nearly 100% of lost intermuscular thigh fat (−5.5±1.6 cm³ vs +5.4±1.4 cm³), while continuing to lose thigh muscle volume (−16.1±5.6 cm³).

Methods

  • Pilot follow-up of 24 older adults (65–79 years; mean age 70±4 years; 50% female; mean BMI 29.9±2.0 kg m⁻²) assessed 18 months after completion of a 5-month randomized trial comparing RT alone with RT+CR.
  • Total body composition was measured by DXA and thigh composition by CT at baseline, 5 months, and 23 months; the parent intervention used supervised RT 3 days/week (3 sets of 10 at 70% 1RM), with RT+CR adding meal replacements, weekly nutrition education, and a target 600 kcal/day reduction.
  • Mixed linear models adjusted for baseline outcome values modeled group, time, and their interaction, with visit-specific group comparisons and P≤0.05 considered statistically significant.

Limitations

  • Stated by the authors: potential selection bias from sampling methods; the a priori decision to ensure differential weight loss prevents intent-to-treat conclusions; limited sample size and resources; findings should be extrapolated only to similar healthy overweight/obese older adults and may differ in older, frail, or more comorbid populations.
  • Evident from the text: this was a small pilot (n=24) not powered for definitive conclusions, and groups were not balanced at baseline for total thigh volume (RT: 1548.6±144.4 cm³ vs RT+CR: 1376.9±122.2 cm³).

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1038/nutd.2016.8

Cites

25 of 25 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 11 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    During postintervention follow-up in RT+CR, thigh muscle volume decreased (P≤0.01).

    “Total fat mass and all thigh fat volumes increased, whereas thigh muscle volume decreased, during the postintervention follow-up in RT+CR (all P⩽0.01).”
    Quote in the paperSubstantial claim
  • Findingown data

    During postintervention follow-up in RT+CR, total fat mass increased (P≤0.01).

    “Total fat mass and all thigh fat volumes increased, whereas thigh muscle volume decreased, during the postintervention follow-up in RT+CR (all P⩽0.01).”
    Quote in the paperSubstantial claim
  • Findingown data

    In the RT+CR group (n=13), mean body mass loss during the 5-month intervention was 7.1±2.4 kg.

    “Mean loss of body mass in the RT+CR group (n=13) was 7.1±2.4 kg during the 5-month intervention”
    • Also stated in: § Between- and within-group differences in total body mass and composition · plain
      “RT+CR participants lost 7.1±2.4 kg of body mass (6.3±3.4% P<0.01) during the intervention”
    Quote in the paperSubstantial claim
  • Findingown data

    In RT+CR, a slightly greater percentage of the total mass regained was comprised of fat compared with the percentage of total mass lost as fat.

    “Thus, a slightly greater percentage of the total mass that was regained was comprised of fat compared with the percentage of total mass that was lost as fat.”
    Quote in the paperNot a substantial claim
  • Findingown data

    In the RT group, body mass did not change from 5 to 23 months (−0.2±0.9 kg; P=0.87).

    “In the RT group, body mass did not change from 5 to 23 months (−0.2±0.9 kg; P=0.87).”
    • Also stated in: § Within-group changes in total body and thigh composition during postintervention follow-up · plain
      “In the RT group, body mass did not change during follow-up (−0.2±0.9 kg; P=0.87).”
    Quote in the paperSubstantial claim
  • May combine two claims. 19
  • Classified as probably not a substantial claim. 5

  • May combine two claims.

    Findingown data

    At 5 months, both total body fat and lean mass were significantly higher in the RT group compared with RT+CR (both P<0.01).

    “both total body fat and lean mass were significantly higher in the RT group compared with the RT+CR at the 5-month time point (both P<0.01).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Of the body mass lost by RT+CR during the 5-month intervention, approximately 74% was fat mass and 26% was lean mass.

    “(74% fat mass; 26% lean mass; all P<0.01)”
    • Also stated in: § Between- and within-group differences in total body mass and composition · hedged
      “with ~74% of mass lost as fat mass and 26% as lean mass (both P<0.01)”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    By 23 months, body mass and lean mass were still lower in RT+CR vs RT (P<0.01), but fat mass was not significantly different between groups.

    “By 23 months, body mass and lean mass were still lower (P<0.01) in the RT+CR vs the RT group, but fat mass was not significantly different between groups.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In the RT-only group, thigh muscle volume and total thigh volume decreased during the 18-month follow-up (both P<0.04), but there were no significant changes in any thigh fat volumes from months 5 to 23.

    “Thigh muscle volume, and thus total thigh volume, decreased during the 18-month follow-up in the RT-only group (both P<0.04), but there were no significant changes in any of the thigh fat volumes from months 5 to 23 (see Table 2).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In RT+CR, most of the thigh fat loss was from the subcutaneous compartment, and ~82% of lost thigh subcutaneous fat was regained during follow-up (−94.7±16.7 cm3 from baseline to 5 months vs +78.1±18.5 cm3 from 5 to 23 months).

    “Examination of changes in thigh intermuscular and subcutaneous fat volumes shows that most of the fat loss was from the subcutaneous compartment, and that ~82% of lost thigh subcutaneous fat was regained during the follow-up period (−94.7±16.7 cm3 from baseline to 5 months vs +78.1±18.5 cm3 from 5 to 23 months).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Group differences in this pilot study show that weight loss via CR during RT results in lower total, subcutaneous and intermuscular thigh fat, as well as lower thigh muscle volumes, compared with RT without weight loss immediately after intervention cessation.

    “Group differences presented in this pilot study show that weight loss via CR during RT results in lower total, subcutaneous and intermuscular thigh fat, as well as lower thigh muscle volumes, compared with RT without weight loss immediately after intervention cessation.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    By 18 months postintervention, despite those who underwent caloric restriction maintaining a lower body mass, none of the group differences in thigh composition were evident; there was a trend (P=0.11) for muscle volume to still be higher in RT vs RT+CR.

    “However, by 18 months postintervention, despite those who underwent caloric restriction maintaining a lower body mass, none of the group differences in thigh composition were evident; there was a trend (P=0.11) for muscle volume to still be higher in RT vs RT+CR.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In the 18 months following the intervention, some amount of weight regain occurred in all RT+CR participants, reflected in fat mass and volume accretion, but thigh muscle volume loss.

    “Specifically, in the 18 months following the intervention, some amount of weight regain occurred in all RT+CR participants, reflected in fat mass and volume accretion, but thigh muscle volume loss.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Even though (on average) RT+CR participants did not regain all lost weight, fat mass or total thigh fat volume by 18 months, thigh muscle volume was lower and all of lost thigh intermuscular fat was regained.

    “Thus, even though (on average) RT+CR participants did not regain all lost weight, fat mass or total thigh fat volume by 18 months, thigh muscle volume was lower and all of lost thigh intermuscular fat was regained.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    During postintervention follow-up, RT+CR lost thigh muscle volume and partially regained total (81%) and subcutaneous (82%) thigh fat, but regained 100% of intermuscular fat.

    “Notably, during the postintervention follow-up, RT+CR lost thigh muscle volume and partially regained total (81%) and subcutaneous (82%) thigh fat, but regained 100% of intermuscular fat.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Our data show that, while both groups lost lean tissue during the postintervention follow-up period, the group that lost and regained weight (RT+CR) also experienced a gain in fat during this same period.

    “Our data show that, while both groups lost lean tissue during the postintervention follow-up period, the group that lost and regained weight (e.g., RT+CR) also experienced a gain in fat during this same period.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    Despite clinically meaningful weight loss and concurrent favorable shifts in total body and thigh composition in participants who lost >5% of initial body mass by undergoing CR during RT, these improvements were generally not sustained long term.

    “Our data indicate that despite clinically meaningful weight loss and concurrent favorable shifts in total body and thigh composition in participants who lost >5% of initial body mass by undergoing CR during RT, these improvements were generally not sustained long term.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The RT group's body composition changes over the 18-month follow-up represent the aging-related changes that would have occurred in the RT+CR group in the absence of weight loss and regain, so that between-group differences can be attributed to the weight-loss/regain cycle.
    • Rests on an assumption: The 7.1 kg (or >5%) weight loss achieved by RT+CR during the 5-month intervention is clinically meaningful.

  • May combine two claims.

    Interpretationown data

    Changes in body composition with weight regain during follow-up show that there is total and regional fat accretion, but loss of lean tissue (particularly thigh muscle volume), implying greater long-term risk for sarcopenic obesity in those who lost weight vs those who did not during RT.

    “Furthermore, changes in body composition with weight regain during the follow-up show that there is total and regional fat accretion, but loss of lean tissue (particularly thigh muscle volume), implying greater long-term risk for sarcopenic obesity in those who lost weight vs those who did not during RT.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The RT group's body composition changes over the 18-month follow-up represent the aging-related changes that would have occurred in the RT+CR group in the absence of weight loss and regain, so that between-group differences can be attributed to the weight-loss/regain cycle.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    At baseline, groups were balanced across all thigh composition variables except total thigh volume, which was higher in RT than RT+CR (1548.6±144.4 vs 1376.9±122.2 cm3).

    “with groups balanced across all variables at baseline, save total thigh volume (1548.6±144.4 vs 1376.9±122.2 cm3 in the RT and RT+CR groups, respectively).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Extrapolation of findings reported here should be limited to similar populations of healthy, but overweight and obese, adults in this age group.

    “Additionally, extrapolation of findings reported here should be limited to similar populations of healthy, but overweight and obese, adults in this age group.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    In postmenopausal women, for every 1 kg of fat mass lost during weight loss, 0.26 kg of lean tissue was lost, whereas for every 1 kg of fat mass regained in the following year, only 0.12 kg of lean tissue was regained.

    “For example, we previously showed that, in postmenopausal women, for every 1 kg of fat mass lost during weight loss, 0.26 kg of lean tissue was lost, whereas for every 1 kg of fat mass regained in the following year, only 0.12 kg of lean tissue was regained.13”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [13] Beavers KM, Lyles MF, Davis CC, Wang X, Beavers DP, Nicklas BJ . Is lost lean mass from intentional weight loss recovered during weight regain in postmenopausal women? Am J Clin Nutr 2011; 94: 767–774. source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    In conclusion, despite clinically meaningful weight loss and concurrent favorable shifts in total body and thigh composition with short-term RT+CR, improvements do not appear to be sustained long-term relative to RT alone.

    “In conclusion, despite clinically meaningful weight loss and concurrent favorable shifts in total body and thigh composition with short-term RT+CR, improvements do not appear to be sustained long-term relative to RT alone.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The RT group's body composition changes over the 18-month follow-up represent the aging-related changes that would have occurred in the RT+CR group in the absence of weight loss and regain, so that between-group differences can be attributed to the weight-loss/regain cycle.
    • Rests on an assumption: The 7.1 kg (or >5%) weight loss achieved by RT+CR during the 5-month intervention is clinically meaningful.

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    Because of limited sample size and resources, a decision was made a priori to ensure differential weight loss was achieved in RT+CR and RT groups.

    “Because of the limited sample size and resources of this pilot project, a decision was made a priori, to ensure differential weight loss was achieved in RT+CR and RT groups.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    In the Look AHEAD trial, although a lifestyle-based caloric restriction and exercise program produced significant fat and lean mass loss during the first year of intervention, 7 years later, 100% of fat mass was regained, whereas participants continued to lose lean mass.

    “Last, recent long-term data from the Look AHEAD trial examining changes in body composition over an 8-year follow-up period demonstrate that although a lifestyle-based caloric restriction and exercise program produced significant fat and lean mass loss during the first year of intervention, 7 years later, 100% of fat mass was regained, whereas participants continued to lose lean mass.25”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [25] Pownall HJ, Bray GA, Wagenknecht LE, Walkup MP, Heshka S, Hubbard VS et al. Changes in body composition over 8 years in a randomized trial of a lifestyle intervention: The look AHEAD study. Obesity (Silver Spring, MD) 2015; 23: 565–572. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Thirty months after completion of a 1-year weight loss intervention in frail, obese older adults, despite continued reduced total body mass from baseline, about one-half (45%) of total fat mass had been regained but lost lean mass was not recovered.

    “Similarly, 30 months after completion of a 1-year weight loss intervention in frail, obese older adults, despite continued reduced total body mass from baseline, about one-half (45%) of total fat mass had been regained but lost lean mass was not recovered.24”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [24] Waters DL, Vawter R, Qualls C, Chode S, Armamento-Villareal R, villareal DT . Long-term maintenance of weight loss after lifestyle intervention in frail, obese older adults. J Nutr Health Aging 2013; 17: 3–7. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Potential selection bias may have occurred because of the sampling methods.

    “Weaknesses include the potential selection bias which may have occurred because of our sampling methods.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given

    Strengths of the study include inclusion of a weight-stable control group, long-term follow-up measures of total body and thigh composition using imaging techniques, and follow-up assessment of the subset of participants who lost a clinically significant amount of weight.

    “Strengths of the current study consist of: (1) inclusion of a weight-stable control group, (2) long-term follow-up measures of total body and thigh composition using imaging techniques and (3) follow-up assessment of the subset of participants who lost a clinically significant amount of weight.”
    Quote in the paperSubstantial claim
22 of 22

  • The paper relies on this without support.

    The RT group's body composition changes over the 18-month follow-up represent the aging-related changes that would have occurred in the RT+CR group in the absence of weight loss and regain, so that between-group differences can be attributed to the weight-loss/regain cycle.

    “inclusion of a weight-stable control group”
    “The purpose of this study was to compare long-term changes in whole body and thigh composition in obese older adults who intentionally lost and then partially regained weight to obese older adults who remained weight stable.”

  • The paper relies on this without support.

    The 7.1 kg (or >5%) weight loss achieved by RT+CR during the 5-month intervention is clinically meaningful.

    “despite clinically meaningful weight loss”
    “participants who lost >5% of initial body mass”
2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Weight regain following caloric restriction interventions appears to preferentially favor increased fat mass versus lean/muscle mass, potentially due to altered lipid oxidation.

    “weight regain following CR interventions appears to preferentially favor increased fat mass vs. lean/muscle mass [123, 133], potentially due to altered lipid oxidation [134].”

    From Targeting Intramyocellular Lipids to Improve Aging Muscle Function (2025) · cites this paper as [123]

  • Human and animal studies report that a greater proportion of fat as a fraction of regained weight following GLP-1 receptor agonist treatment exceeds that seen when combined with exercise or compared with exercise alone.

    “human and animal studies report a greater proportion of fat as a fraction regained weight following GLP-1 receptor agonist treatment has been shown to exceed that seen when it is combined with exercise or as compared to exercise alone [123, 135].”

    From Targeting Intramyocellular Lipids to Improve Aging Muscle Function (2025) · cites this paper as [123]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Conflicting 23-month P values for between-group body mass

    Minor

    The abstract reports P=0.03 for the 23-month body-mass comparison, while the Results report P<0.01 for that comparison.

  • Follow-up change is defined with the opposite sign from the reported gain

    Minor

    The statistical methods define follow-up change as the 23-month value subtracted from the 5-month value. Under that definition, weight regain would be negative, but the Results report it as positive.

2 of 2

Cites

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1 of the 26 references couldn’t be matched to a known paper.

Cited by

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Related

Authors
Chmelo, E. A., Beavers, D. P., Lyles, M. F., Marsh, A. P., Nicklas, B. J., & Beavers, K. M.
Affiliations
  • Wake Forest University Health Sciences (US)
  • Wake Forest University (US)
Corresponding author
Chmelo, E A
ORCID
Venue
Nutrition & Diabetes
Publisher
Springer Science and Business Media LLC
Published
2016-04-04
Volume
6
Issue
4
Pages
e203-e203
ISSN
2044-4052 (ISSN-L)
DOI
10.1038/nutd.2016.8
PMC
PMC4855260
OpenAlex
W2344947331
Semantic Scholar
2c299b620426d2e8f02dd69ba9f2839d613e9684
Cited by
15
References
26
Citations by year
2026: 1 · 2025: 2 · 2024: 2 · 2023: 1 · 2022: 1 · 2021: 1 · 2020: 2 · 2019: 3 · 2018: 2
FWCI
1.34
Type
journal article
Language
en
Open access
Licence
Locations
  • Nutrition and Diabetes (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
  • Wake Forest School of Medicine
  • National Institute on Aging (R01AG020583, P30AG-21332, P30AG021332)
Topics
  • Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
  • Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords
weight regain, intentional weight loss, body composition, older adults, obesity, overweight, resistance training, caloric restriction, fat mass, lean body mass, thigh muscle volume, long-term follow-up
MeSH terms
Aged, Body Composition, Energy Intake, Female, Follow-Up Studies, Humans, Male, Obesity, Pilot Projects, Thigh, Time Factors, Weight Loss, Absorptiometry, Photon, Body Mass Index, Muscle, Skeletal, Caloric Restriction, Overweight, Resistance Training

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