Weight Loss and Exercise
Obesity increases the physical and functional deterioration associated with aging. This study evaluated the effect of weight loss induced by diet and physical exercise on quality of life and physical composition of the obese elderly.
This study included a voluntary basis to 27 frail obese elderly men and women, who were divided into two groups randomly: control group (10 patients) and those receiving treatment (17 patients).
More patients were included in the treatment group to evaluate a greater number of obese elderly the effects of diet and exercise.
The treatment consisted of twenty-six weeks of balanced diet, and had a target weight loss of about 10% at the end of the study. Additionally, patients who participated in group exercises three times a week on nonconsecutive days, supervised by physical therapists.
Patients were instructed to maintain control group diet and usual activities during the study.
The objective was to assess physical function, with measurements for assessing the frailty (physical performance test, maximal oxygen consumption and a questionnaire on functional status), progress tests, balance and strength.
We also assessed body composition with a study of dual-energy absorption and quality of life through health survey in an abbreviated form of 36 questions. After 26 weeks patients were reevaluated.
The staff performing the evaluations did not know the group that was evaluated. The average attendance for groups of behavior therapy and diet was 86.5% and workouts of 84.1%.
None of the participants suffered from adverse effects it internally, or liver or kidney function.
The results showed that the treatment group lost 8.2 kg (8.4%) of body weight (p less than 0.01), while the control group maintained a constant weight.
Besides decreased body fat (p less than 0.01) but not the lean tissue of patients in the treated group.
Weight loss and exercise improved objective and subjective measures of fragility.
There was a significant improvement in test scores, without observing changes in the control group. Patients also expressed a subjective improvement of function and health perception.
This is the first randomized controlled trial to evaluate the effect of weight loss and exercise in frail obese elderly. The results show that the fragility can be reversed with diet and physical activity, without producing sarcopenia by loss of lean tissue.
Therefore this should be considered first-line treatment, given that obesity is a major cause of frailty in the elderly and leads to loss of independence, and increased morbidity and mortality and institutionalization of these patients. The most important goal for obese elderly would improve their physical function and quality of life.
While this study demonstrates the possibility of achieving a change in the lifestyle of obese older adults, we must take into account that the enrolled patients were volunteers and therefore are motivated.
We also evaluated the effect of diet and exercise together and not separately, but preliminary data suggest an independent effect for each.
This study lasted only six months, it would be necessary to conduct new tests to assess the effect of weight loss and exercise after a long time.
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