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/m(2)) 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.