Body weight dynamics following intentional weight loss and physical performance: the Look AHEAD Movement and Memory Study

Objective The aim of this study was to explore the impact of body weight change following intentional weight loss on measures of physical performance in adults with diabetes. Design and methods Four hundred fifty individuals with type 2 diabetes (age, 59.0 ± 6.9 years; body mass index, 35.5 ± 5.9 kg/m2) who participated in the Look AHEAD Movement and Memory Study and lost weight 1 year after being randomized to an intensive lifestyle intervention were assessed. Body weight was measured annually, and participants were categorized as continued losers/maintainers, regainers, or cyclers based on a ±5% annual change in weight. Objective measures of physical performance were measured at the year 8/9 visit. Results Forty-four percent, 38% and 18% of participants were classified as regainers, cyclers, and continued losers/maintainers, respectively. In women, weight cycling and regain were associated with worse follow-up expanded physical performance battery score (1.46 ± 0.07 and 1.48 ± 0.07 vs. 1.63 ± 0.07, both p ≤ 0.02) and slower 20-m walking speed (1.10 ± 0.04 and 1.08 ± 0.04 vs. 1.17 ± 0.04 m/s, both p < 0.05) compared with continued or maintained weight loss. Male cyclers presented with weaker grip strength compared with regainers or continued losers/maintainers (30.12 ± 2.21 vs. 34.46 ± 2.04 and 37.39 ± 2.26 kg; both p < 0.01). Conclusions Weight cycling and regain following intentional weight loss in older adults with diabetes were associated with worse physical function in women and grip strength in men.