Cardiometabolic and Fitness Improvements in Obese Girls Who Either Gained or Lost Weight during Treatment

Objective To evaluate the quality of weight change (change in fat mass vs fat-free mass [ FFM]), changes in cardiorespiratory fitness (CRF), and frequencies of metabolic risk factors in adolescent females with obesity who either lost or gained weight following lifestyle treatment. Study design Fifty-eight girls (mean age = 13.0 +/- 1.6 years; 77% black; mean body mass index = 36.5 +/- 4.5 kg/ m(2)) completed a 6-month lifestyle intervention combining dietary and behavioral counseling with aerobic and resistance exercise training. We examined baseline to 6-month differences in weight (kg), body composition, CRF, and frequencies of metabolic risk factors between weight loss and weight gain groups. Results In the weight loss group, body weight (-4.50 +/- 3.53 kg, P < .001), fat mass (-4.50 +/- 2.20 kg, P < .001), and body fat percentage (-2.97% +/- 1.45%, P < .001) decreased, and FFM was unchanged at 6 months. In the weight gain group, body weight (4.50 +/- 2.20 kg, P < .001), fat mass (1.52 +/- 3.16 kg, P < .024), and FFM (2.99 +/- 2.45 kg, P < .001) increased, and body fat percentage was unchanged. Both groups improved CRF (P < .05). Frequencies of metabolic risk factors were reduced across all participants after the 6-month treatment. Conclusions Participation in a weight management program might elicit health improvements in obese adolescent females who increase weight and fat mass, provided that FFM gains are sufficient to negate increases in body fat percentage.