Even though the monetary and health costs of obesity are
substantial, intentional weight loss has not been advocated for
older people, because a relationship between weight loss and
increased rates of hip fractures and mortality has been
demonstrated. However, intentional weight loss as opposed to
unintentional weight loss has actually been shown to decrease
total mortality in older adults. Even small weight losses of 5
to 10% have been shown to result in increased physical function
and health-related quality of life, yet standard exercise
programs for older adults often do not result in any weight
loss. One example of this is cardiac rehabilitation (CR), which
generally results in insignificant weight loss over a 3-month
time frame. However, even the highest-risk overweight patients
can lose fat and overall weight, as well as achieve a more
favorable cardiometabolic risk profile, when encouraged to
participate in a high-calorie-expenditure (HCE) exercise program
rather than a standard CR protocol. Recent evi