In the Journals

Fluctuations after weight loss diminish physical performance in adults with diabetes

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September 29, 2015

Weight cycling and regaining after a period of intentional weight loss is associated with worse physical function in women and weaker grip strength in men with diabetes, according to research in Obesity Science & Practice.

“Importantly, for weight cyclers, this was true despite a relatively small increase in absolute weight over time,” Kristen M. Beavers, PhD, assistant professor of health and exercise science at Wake Forest University, told Endocrine Today.

Beavers and colleagues analyzed data from 450 adults aged 45 to 76 years with type 2 diabetes and a BMI greater than 25 kg/m² (250 women; mean age, 59 years; mean BMI, 35.5 kg/m²) who participated in the Look AHEAD Movement and Memory Study and who lost weight 1 year after randomly assigned an intensive lifestyle intervention. The Movement and Memory Study assessed objective measures of physical function with standing balance tasks, timed chair stands and a timed 4-minute walk; 20-minute walking speed, 400-m walking endurance and grip strength were also measured.

Weight was measured annually for 8 years. Researchers categorized participants as continued “losers/maintainers” if their weight changed by less than 5% from the prior year and from the year 1 weight, “regainers” if they gained 5% or more from the prior year and the year 1 weight, and “continued losers” if they lost 5% or more from the prior year and year 1 weight. Having a combination of “loser” and “gainer” across yearly categories would result in an overall “cycler” categorization.

Within the cohort, 44% of participants were classified as regainers; 38% were classified as cyclers; 18% were classified as losers or maintainers. When compared with women who were classified as continued losers/maintainers, women who were cyclers or regainers performed worse on follow-up expanded physical performance battery scores and had slower 20-minute walking speeds. Male weight cyclers had a weaker grip strength when compared with regainers or continued losers/maintainers.

“Given the known immediate benefit of weight loss on physical performance measures, adoption of effective weight loss maintenance strategies may have the potential to maintain and preserve independent living in overweight and obese middle-aged and older adults with diabetes,” Beavers said. “Clinicians working with this population should emphasize stable weight loss maintenance for prolonged functional independence.

“We speculate that the negative effect of weight cycling on measures of physical performance may be due to a net increase in fat mass (compared to lean mass) over time,” Beavers said. “Testing of this hypothesis using longitudinal, validated measures of body composition should be the focus of future work.” – by Regina Schaffer

Disclosure: Beavers and the other researchers report no relevant financial disclosures.

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