• body composition [ Time Frame: one year ] [ Designated as safety issue: No ]
• muscle protein synthesis [ Time Frame: one year ] [ Designated as safety issue: No ]
• quality of life [ Time Frame: one year ] [ Designated as safety issue: No ]
• cognition and mood [ Time Frame: one year ] [ Designated as safety issue: No ]
• metabolism [ Time Frame: one year ] [ Designated as safety issue: No ]
• bone mineral density [ Time Frame: 1 year ] [ Designated as safety issue: Yes ]

The purpose of this study is to determine the effect of weight loss and exercise on physical function, body fat and muscle mass, bone strength, and quality of life.

Obesity causes serious medical complications and impairs quality of life. Moreover, in elderly persons, obesity can lead to frailty by exacerbating the decline in strength, endurance, balance and mobility associated with aging and physical inactivity. The primary objectives of the proposed research are to evaluate the independent and combined effects of weight loss and exercise on physical function, body composition, bone and muscle metabolism, and quality of life in frail, obese elderly men and women. The central hypothesis is that in frail obese elderly subjects, weight loss will improve physical function and quality of life, while the addition of exercise will not only augment improvement in these outcomes, but also attenuate the adverse effects of weight loss on bone and muscle masses. To test this hypothesis, 110 elderly (65-85 years old) obese men and women (body mass index [BMI] > 30 kg/m2) with physical frailty will be randomized to 4 treatment groups: 1) control, 2) 10% weight loss, 3) exercise training, and 4) 10% weight loss plus exercise training.

• Behavioral: Diet
• Other: Exercise
• Other: Weight Loss and Exercise

• Experimental: Weight loss
• Experimental: Exercise
• Experimental: Weight loss and exercise

Inclusion Criteria:

• Obese (BMI 30 or greater)
• Elderly (age 65 years or older)
• Frailty

Exclusion Criteria:

• Major chronic disease or any condition that would interfere with exercise or dietary restriction, in which exercise or dietary restriction are contraindicated, or that would interfere with interpretation of results.
• Examples include cardiopulmonary disease, unstable disease, severe orthopedic or neuromuscular impairments, dementia, history of malignancy during the past 5 years, or current use of bone acting drugs.