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Cited by 18Nutrition and Health in AgingObesity, Physical Activity, DietPhysical Activity and Health

Therapeutic and lifestyle approaches to obesity in older persons

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Jiang, Bryan C., Villareal, Dennis T.·2019·Current Opinion in Clinical Nutrition & Metabolic Care
DOI 10.1097/mco.0000000000000520PMC PMC6265116
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Abstract

PURPOSE OF REVIEW: Obesity rates worldwide continue to increase and will disproportionately affect older adults because of population aging. This review highlights recent progress pertaining to therapeutic approaches to obesity in older adults. RECENT FINDINGS: Caloric restriction alone improves physical function and quality of life in older adults with obesity but is associated with loss of lean mass and increases fracture risk. Adding progressive resistance training to caloric restriction attenuates loss of muscle and bone mass and increasing protein intake enhances this effect. Adding aerobic endurance training to caloric restriction further improves cardiorespiratory fitness but adding both aerobic endurance training and resistance training to caloric restriction results in the greatest improvement in overall physical function while still preserving lean mass. Future promising therapeutic interventions include testosterone, myostatin inhibitors, and bariatric surgery, but there are few studies specific to obese older adults. SUMMARY: The optimal approach toward obesity in older persons is lifestyle intervention incorporating caloric restriction and exercise consisting of aerobic endurance training and resistance training. Maintenance of adequate protein intake, calcium, and vitamin D is advisable. There is insufficient evidence specific to obese older adults to recommend testosterone or bariatric surgery at this time. Myostatin inhibitors may become a future treatment, and clinical trials are ongoing.

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  • Weight loss improves physical function and quality of life in patients with obesity.

    “weight loss improves measurable outcomes in physical function and quality of life for patients with obesity (8).”

    From The Benefits of Exercise Training in Combination With Weight Loss Therapies (2025) · cites this paper as [8]

    The Caloric Restriction section (page not provided) says caloric restriction improves measurable physical-function and quality-of-life outcomes in older adults with obesity. The citing sentence omits that age restriction and applies the finding to patients with obesity generally. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Combining weight loss with concurrent exercise yields better outcomes than either intervention alone.

    “combining weight loss with concurrent exercise yields better outcomes than either intervention alone (8).”

    From The Benefits of Exercise Training in Combination With Weight Loss Therapies (2025) · cites this paper as [8]

  • Adding exercise training to calorie-restriction-induced weight loss attenuates decline in lean mass and bone mineral density when adequate protein and micronutrient intake is ensured.

    “the addition of exercise training to CR-induced weight loss attenuates the decline in lean mass and BMD when adequate protein and micronutrient intake is ensured (6,8).”

    From The Benefits of Exercise Training in Combination With Weight Loss Therapies (2025) · cites this paper as [8]

  • Exercise training reduces the loss of lean mass and bone mineral density in patients who lose weight through caloric restriction and behavioral modification.

    “Given the established benefits of exercise training in reducing the loss of lean mass and BMD in patients undergoing CR-induced weight loss through behavioral modification (8)”

    From The Benefits of Exercise Training in Combination With Weight Loss Therapies (2025) · cites this paper as [8]

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Cited by

Sorted by citations

Authors
Jiang, B. C., & Villareal, D. T.
Affiliations
Michael E. DeBakey VA Medical Center (US)
Corresponding author
Villareal, Dennis T.
ORCID
Villareal, Dennis T.
Venue
Current Opinion in Clinical Nutrition & Metabolic Care
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2019-01
Volume
22
Issue
1
Pages
30-36
ISSN
1363-1950 (ISSN-L)
DOI
10.1097/mco.0000000000000520
PMC
PMC6265116
OpenAlex
W2897174681
Cited by
18
References
8
Citations by year
2025: 1 · 2024: 1 · 2023: 4 · 2022: 3 · 2021: 6 · 2019: 1 · 2018: 2
FWCI
0.30
Type
journal article
Language
en
Open access
Locations
  • Current Opinion in Clinical Nutrition & Metabolic Care (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • American Diabetes Association
  • U.S. Department of Veterans Affairs (I01 CX000906)
  • Office of Research and Development
  • Rural Development Administration
  • National Institutes of Health (7r01ag025501-06)
  • National Institute on Aging (R01-AG025501, R01AG031176)
  • National Institute of Diabetes and Digestive and Kidney Diseases (R01DK109950)
Topics
  • Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
Keywords
obesity, older adults, caloric restriction, resistance training, aerobic endurance training, protein intake, lean mass preservation, fracture risk, physical function, testosterone, myostatin inhibitors, bariatric surgery, lifestyle intervention, aging
MeSH terms
Healthy Lifestyle, Physical Functional Performance, Endurance Training, Aged, Calcium, Dietary, Dietary Proteins, Exercise Therapy, Humans, Obesity, Vitamin D, Exercise, Caloric Restriction, Resistance Training, Elder Nutritional Physiological Phenomena

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