The Journal of Frailty & Aging

, Volume 7, Issue 3, pp 198–203 | Cite as

Feasibility of Weighted Vest Use During A Dietary Weight Loss Intervention and Effects on Body Composition and Physical Function in Older Adults

  • E. Normandin
  • D. Yow
  • C. Crotts
  • J. Kiel
  • K.M. Beavers
  • Barbara J. Nicklas
Original Research



While intentional weight loss in older adults with obesity yields clinically important health benefits there is a need to minimize the negative effects of weight loss on concomitant loss of muscle mass and strength. Data show wearing weighted vests during exercise improves lean mass and lower extremity strength, however the efficacy of wearing a weighted vest during a period of weight loss to mitigate muscle and strength loss is not known.


This study examined the feasibility of daily weighted vest use during a dietary weight loss intervention, and examined effects of vest use on body composition and physical function in well-functioning older adults with obesity.


Randomized, controlled pilot study.


Wake Forest Baptist Medical Center in Winston-Salem, NC.


37 older (age=65-79 yrs), obese (BMI=30-40 kg/ m2) sedentary men and women.


22-week behavioral diet intervention (targeting 10% weight loss, 1100–1300 kcals/day) with (Diet+Vest; n=20) or without (Diet; n=17) weighted vest use (goal of 10 hours/ day with weight added weekly according to individual loss of body mass).


Body composition by dual-energy x-ray absorptiometry and measures of physical function, mobility, and muscle strength/power.


Average weighted vest use was 6.7±2.2 hours/day and the vest-wear goal of 10 hrs/day was achieved for 67±22% of total intervention days. Five participants reported adverse events from wearing the vest (all back pain or soreness). Both groups lost a similar amount of weight (Diet= -11.2±4.4 kg; Diet+Vest = -11.0±6.3 kg; p<0.001), with no differences between groups (p=0.25). Fat mass, lean mass, and % body fat decreased significantly (p<0.0001), with no differences between groups. Compared to Diet+Vest, the Diet intervention resulted in greater decreases in leg power (p<0.02), with no other between group differences in physical function.


This pilot study showed that vest use during dietary weight loss is feasible and safe in well-functioning older adults with obesity. Larger studies are needed to definitively determine whether external replacement of lost weight during caloric restriction may preserve lower extremity muscle strength and power.

Key words

Caloric restriction weighted vest body composition physical function weight loss 


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  1. 1.
    Fakhouri TH, Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity among older adults in the United States, 2007–2010. NCHS Data Brief. 2012:1–8.Google Scholar
  2. 2.
    (IDB). UCBID. Population projections of the USby age, sex, race, Hispanic origin, population division. 2016.Google Scholar
  3. 3.
    Rillamas-Sun E, LaCroix AZ, Waring ME, et al. Obesity and late-age survival without major disease or disability in older women. JAMA Int Med. 2014;174:98–106.CrossRefGoogle Scholar
  4. 4.
    Iwao S, Iwao N, Muller DC, Elahi D, Shimokata H, Andres R. Effect of aging on the relationship between multiple risk factors and waist circumference. J Am Geriatr Soc. 2000;48:788–794.CrossRefPubMedGoogle Scholar
  5. 5.
    Sarkisian CA, Liu H, Gutierrez PR, Seeley DG, Cummings SR, Mangione CM. Modifiable risk factors predict functional decline among older women: a prospectively validated clinical prediction tool. The Study of Osteoporotic Fractures Research Group. J Am Geriatr Soc. 2000;48:170–178.CrossRefPubMedGoogle Scholar
  6. 6.
    Villareal DT, Chode S, Parimi N, et al. Weight loss, exercise, or both and physical function in obese older adults. N Engl J Med. 2011;364:1218–1229.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Normandin E, Houston DK, Nicklas BJ. Caloric restriction for treatment of geriatric obesity: Do the benefits outweigh the risks? Current nutrition reports. 2015;4:143–155.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Waters DL, Ward AL, Villareal DT. Weight loss in obese adults 65years and older: a review of the controversy. Exp Gerontol. 2013;48:1054–1061.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Weinheimer EM, Sands LP, Campbell WW. A systematic review of the separate and combined effects of energy restriction and exercise on fat-free mass in middle-aged and older adults: implications for sarcopenic obesity. Nutr Rev. 2010;68:375–388.CrossRefPubMedGoogle Scholar
  10. 10.
    Bales CW, Buhr G. Is obesity bad for older persons? A systematic review of the pros and cons of weight reduction in later life. J Am Med Dir Assoc. 2008;9:302–312.CrossRefPubMedGoogle Scholar
  11. 11.
    Jensen MD, Ryan DH, Apovian CM, et al. 201. AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation. 2014;129:S102–138.CrossRefPubMedGoogle Scholar
  12. 12.
    Ekkekakis P, Lind E, Vazou S. Affective responses to increasing levels of exercise intensity in normal-weight, overweight, and obese middle-aged women. Obesity (Silver Spring). 2010;18:79–85.CrossRefGoogle Scholar
  13. 13.
    Washburn RA, Smith KW, Jette AM, Janney CA. The Physical Activity Scale for the Elderly (PASE): Development and evaluation. J Clin Epidemiol. 1993;46:153–162.CrossRefPubMedGoogle Scholar
  14. 14.
    Pette. Gabriel KK, Rankin RL, Lee C, Charlton ME, Swan PD, Ainsworth BE. Test-retest reliability and validity of the 400-meter walk test in healthy, middle-aged women. Journal of physical activity & health. 2010;7:649–657.CrossRefGoogle Scholar
  15. 15.
    Bassey EJ, Short AH. A new method for measuring power output in a single leg extension: feasibility, reliability and validity. European journal of applied physiology and occupational physiology. 1990;60:385–390.CrossRefPubMedGoogle Scholar
  16. 16.
    Guralnik JM, Fried LP, Salive ME. Disability as a public health outcome in the aging population. Annu Rev Public Health. 1996;17:25–46.CrossRefPubMedGoogle Scholar
  17. 17.
    Vincent HK, Vincent KR, Lamb KM. Obesity and mobility disability in the older adult. Obes Rev. 2010;11:568–579.CrossRefPubMedGoogle Scholar
  18. 18.
    Nicklas BJ, Chmelo E, Delbono O, Carr JJ, Lyles MF, Marsh AP. Effects of resistance training with and without caloric restriction on physical function and mobility in overweight and obese older adults: a randomized controlled trial. Am J Clin Nutr. 2015;101:991–999.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Beavers KM, Gordon MM, Easter L, et al. Effect of protein source during weight loss on body composition, cardiometabolic risk and physical performance in abdominally obese, older adults: a pilot feeding study. J Nutr Health Aging. 2015;19:87–95.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Shapses SA, Sukumar D. Bone metabolism in obesity and weight loss. Annu Rev Nutr. 2012;32:287–309.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Silver FH, Siperko LM. Mechanosensing and mechanochemical transduction: how is mechanical energy sensed and converted into chemical energy in an extracellular matrix? Critical reviews in biomedical engineering. 2003;31:255–331.CrossRefPubMedGoogle Scholar
  22. 22.
    Frimel TN, Sinacore DR, Villareal DT. Exercise attenuates the weight-lossinduced reduction in muscle mass in frail obese older adults. Med Sci Sports Exerc. 2008;40:1213–1219.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Chomentowski P, Dube JJ, Amati F, et al. Moderate exercise attenuates the loss of skeletal muscle mass that occurs with intentional caloric restriction-induced weight loss in older, overweight to obese adults. J Gerontol A Biol Sci Med Sci. 2009;64:575–580.CrossRefPubMedGoogle Scholar
  24. 24.
    Marden JH, Fescemyer HW, Saastamoinen M, et al. Weight and nutrition affect premRNA splicing of a muscle gene associated with performance, energetics and life history. The Journal of experimental biology. 2008;211:3653–3660.CrossRefPubMedGoogle Scholar
  25. 25.
    Klentrou P, Slack J, Roy B, Ladouceur M. Effects of exercise training with weighted vests on bone turnover and isokinetic strength in postmenopausal women. Journal of aging and physical activity. 2007;15:287–299.CrossRefPubMedGoogle Scholar
  26. 26.
    Bean J, Herman S, Kiely DK, et al. Weighted stair climbing in mobility-limited older people: a pilot study. J Am Geriatr Soc. 2002;50:663–670.CrossRefPubMedGoogle Scholar
  27. 27.
    Bean JF, Herman S, Kiely DK, et al. Increased velocity exercise specific to task (InVEST) training: a pilot study exploring effects on leg power, balance, and mobility in community-dwelling older women. J Am Geriatr Soc. 2004;52:799–804.CrossRefPubMedGoogle Scholar
  28. 28.
    Nicklas BJ, Chmelo E, Delbono O, Carr JJ, Lyles MF, Marsh AP. Effects of resistance training with and without caloric restriction on physical function and mobility in overweight and obese older adults: A randomized controlled trial. Am J Clin Nutr. 2015;101(5):991–999.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Serdi and Springer Nature Switzerland AG 2018

Authors and Affiliations

  • E. Normandin
    • 1
  • D. Yow
    • 1
  • C. Crotts
    • 1
  • J. Kiel
    • 2
  • K.M. Beavers
    • 3
  • Barbara J. Nicklas
    • 1
    • 3
    • 4
  1. 1.Section on Gerontology and Geriatric MedicineWake Forest School of MedicineWinston-SalemUSA
  2. 2.Department of Scientific and Clinical AffairsMedifast, Inc.BaltimoreUSA
  3. 3.Department of Health and Exercise ScienceWake Forest UniversityWinston-SalemUSA
  4. 4.Section on Gerontology and Geriatric Medicine, Department of Internal MedicineWake Forest School of Medicine, Medical Center BoulevardWinston-SalemUSA

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