Weighted Vests Preserve Resting Energy Expenditure During Intentional Weight Loss in Older Adults

TL;DR

Wearing a weighted vest during weight loss in older adults may help prevent weight regain by maintaining energy expenditure.

Contribution

The study shows that using a weighted vest preserves resting energy expenditure better than weight loss alone or with resistance training.

Findings

Weighted vest use preserved resting energy expenditure more than other methods at 12 months.

Participants using a weighted vest regained less weight over 24 months compared to others.

The study supports the gravitostat theory in mitigating signals that drive weight regain.

Abstract

Weight regain following intentional weight loss in older adults is a near expected occurrence. The gravitostat theory suggests that gravitational loading – in the form of a weighted vest, for instance – might dampen the body’s perception of weight loss, thus mitigating signals driving weight regain, such as reduced resting energy expenditure (REE). The 12-month INVEST in Bone Health Trial (NCT04076618), compared WL alone (targeting 10% WL), WL plus weighted vest use (WL+VEST; 8 hours/day, weight replacement up to 10% total WL), or WL plus resistance training (WL+RT; 3 supervised sessions/week) on bone health in 150 older adults, is an ideal platform to examine this concept. A subset of participants (n = 21) with baseline characteristics similar to the original cohort (66.9±5.4 years; 71% women; 67% white; body mass index [BMI] 33.3±3.5 kg/m²) returned for a 24-month follow up visit (12 months post-intervention) to collect REE and body weight. At intervention end (12-months), REE was better preserved in WL+VEST [+146.9 kcal/day (95% CI: 32.4, 222.4)] compared to WL alone [-52.5 kcal/day (95% CI: -137.5, 32.5)] and WL+RT [-89.7 kcal/day (95% CI: -160.5, -18.8)]; p = 0.02. From 12 to 24 months, WL+VEST regained the least weight [+0.74 kg (95% CI:(-3.75, 5.23)], compared to WL+RT [+4.74 kg (95% CI: 0.51, 8.96)] and WL alone [+4.40 kg (95% CI (2.03, 6.77)]; p = 0.084. Findings suggest that weighted vest use may attenuate long-term weight regain in older adults by preserving REE. Future work will examine other measures of energy balance, including physical activity energy expenditure and appetite hormones.