Fat mass loss predicts gain in physical function with intentional weight loss in older adults
Open accessAbstract
BACKGROUND: Clinical recommendation of weight loss (WL) in older adults remains controversial, partially due to concerns regarding lean mass loss and potential loss of physical function. The purpose of this study is to determine the independent associations between changes in fat and lean mass and changes in physical function in older, overweight, and obese adults undergoing intentional WL. METHODS: Data from three randomized-controlled trials of intentional WL in older adults with similar functional outcomes (short physical performance battery and Pepper assessment tool for disability) were combined. Analyses of covariance models were used to investigate relationships between changes in weight, fat, and lean mass (acquired using dual-energy x-ray absorptiometry) and changes in physical function. RESULTS: Overall loss of body weight was -7.8 ± 6.1 kg (-5.6 ± 4.1 kg and -2.7 ± 2.4 kg of fat and lean mass, respectively). In all studies combined, after adjustment for age, sex, and height, overall WL was associated with significant improvements in self-reported mobility disability (p < .01) and walking speed (p < .01). Models including change in both fat and lean mass as independent variables found only the change in fat mass to significantly predict change in mobility disability (β[fat] = 0.04; p < .01) and walking speed (β[fat] = -0.01; p < .01). CONCLUSIONS: Results from this study demonstrate that loss of body weight, following intentional WL, is associated with significant improvement in self-reported mobility disability and walking speed in overweight and obese older adults. Importantly, fat mass loss was found to be a more significant predictor of change in physical function than lean mass loss.
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Functional improvements after lifestyle or surgical weight loss are often attributed to fat-loss-associated improvements in muscle quality.
“Functional improvements following lifestyle or surgical weight loss are often attributed to fat-loss associated improvements in muscle quality (38, 39).”
From <scp>G</scp> <scp>LP1Ra</scp> ‐based therapies and <scp>DXA</scp> ‐acquired musculoskeletal health outcomes: a focused meta‐analysis of placebo‐controlled trials (2025) · cites this paper as [39]
The Discussion (page unavailable) reports that fat-mass loss predicts improved gait speed and mobility in older adults and identifies muscle quality, rather than muscle quantity, as important to physical performance. It does not establish that improved muscle quality mediates the gains after fat loss, and the studies analyzed did not examine surgical weight loss. (LLM, conf=0.86)
Experimental — accuracy not yet measuredWeight loss improves global physical function, most likely because of reduced fat mass.
“weight loss improves global physical function, most likely because of reduced fat mass”
From Preserving Healthy Muscle during Weight Loss (2017) · cites this paper as [128]
The Discussion reports that fat mass loss predicts improvements in gait speed and mobility during intentional weight loss in older adults. The claim broadens those measured outcomes to global physical function and suggests a causal explanation, whereas the Discussion says the causal mechanisms have not been fully established. (LLM, conf=0.85)
Experimental — accuracy not yet measuredThe improvements in physical function after diet-induced weight loss are most likely due to the loss of excess total body fat mass.
“The improvements in physical function after diet-induced weight loss are most likely due to the loss of excess total body fat mass (128), which can interfere with range of motion, gait, etc.”
From Preserving Healthy Muscle during Weight Loss (2017) · cites this paper as [128]
The Discussion reports that fat mass loss predicts improvements in gait speed and mobility during intentional weight loss in older adults. It also says the causal mechanisms have not been fully elucidated and calls for studies of weight loss without concomitant exercise, so the claim that improvements after diet-induced weight loss are most likely due to fat loss is stronger and broader than the paper establishes. (LLM, conf=0.86)
Experimental — accuracy not yet measuredFat mass loss is a stronger predictor of functional improvements with weight loss than is lean mass loss.
“Fat mass loss is a stronger predictor of functional improvements with weight loss than is lean mass loss (46).”
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Self-citation
- Authors
- Beavers, K. M., Miller, M. E., Rejeski, W. J., Nicklas, B. J., & Kritchevsky, S. B.
- Affiliations
- Wake Forest University Health Sciences (US)
- Wake Forest University (US)
- National Center for Geriatrics and Gerontology (JP)
- Venue
- The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
- Publisher
- Oxford University Press (OUP)
- Published
- 2012-04-13
- Volume
- 68
- Issue
- 1
- Pages
- 80-86
- ISSN
- 1079-5006 (ISSN-L)
- 1758-535X
- PMC
- PMC3598365
- OpenAlex
- W2103771935
- Semantic Scholar
- 781d1df2ff56531f5a8fea7471dedb86d8dd992d
- Cited by
- 82
- References
- 40
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 3 · 2023: 4 · 2022: 2 · 2021: 4 · 2020: 6 · 2019: 11 · 2018: 5 · 2017: 6 · 2016: 4 · 2015: 11 · 2014: 10 · 2013: 6 · 2012: 2
- FWCI
- 6.22
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journals of Gerontology Series A (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (R01-AG/DK20583, R01AG020583, P30AG-21332, F32AG039186, P30AG028740, P30AG021332)
- National Heart, Lung, and Blood Institute (R01HL093713, R01HL076441)
- National Center for Research Resources (M01RR-07122, M01RR007122)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Keywords
- intentional weight loss, older adults, fat loss, lean mass loss, physical function, mobility impairment, walking speed, obesity, overweight, Short Physical Performance Battery, disability assessment
- MeSH terms
- Adipose Tissue, Aged, Aging, Body Composition, Disability Evaluation, Female, Humans, Male, Middle Aged, Models, Biological, Obesity, Physical Fitness, Risk Factors, Weight Loss, Walking, Overweight, Sarcopenia, Weight Reduction Programs
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