Weight loss alone or exercise alone improves physical function
and ameliorates frailty in obese older adults. However, a
combination of weight loss and exercise provides greater benefit
than either intervention alone. Villareal and coworkers
conducted a randomized controlled trial of 107 obese older
adults. Patients were randomly assigned to a control, weight-
management (diet), exercise, or weight-management-plus-exercise
(diet-exercise) group. The primary outcome was the change in the
score on the modified Physical Performance Test, a measure of
frailty. Secondary outcomes included other measures of frailty,
body composition, and quality of life. The mean scores on the
Physical Performance Test increased more in the diet-exercise
group (21%) than in the diet (12%) or exercise group (15%);
control group scores increased by 1%. The peak oxygen
consumption improved more in the diet-exercise group (17%) than
in the diet (10%) or exercise group (8%). The score on the
Functional Status Questionnaire increased more