Weighted Vest Use or Resistance Exercise to Offset Weight Loss–Associated Bone Loss in Older Adults: A Randomized Clinical Trial
An erratum to this article was published (JAMA Netw Open, 1 Aug 2025 ↗)
Authors' conclusion
In this 12-month randomized clinical trial, neither weighted vest use nor progressive RT was able to mitigate WL-associated bone loss at the hip in older adults living with obesity. This study highlights the need for alternative or adjunctive strategies to prevent bone loss in older adults experiencing WL because exercise may be insufficient on its own.
Study context
- Population
- Older adults living with obesity at an academic medical center; mean age 66.4 (SD 4.6) years, 74.7% women, mean BMI 33.6133 completed
- Participants
- 150 adults
- Comparison
- Weight loss (WL)+VEST vs WL alone and vs WL+resistance training (RT)
- WLn = 50reference
- WL+VESTn = 50
- WL+RTn = 50
- Primary endpoint
- Change in CT-acquired total hip trabecular vBMD and DXA-acquired total hip aBMD
- Follow-up
- 12 months
Methodological detailssingle-blind, 12-month, noninferiority
- Single-blind
- 12-month
- Noninferiority
Primary result
As reported in the abstract
Estimated treatment difference
+0.91 mg/cm³
97.5% CI −0.27 to 2.09P = 0.13
WL+VEST vs WL · no difference
Estimated treatment difference
+0.29 mg/cm³
WL+VEST vs WL+RT · 98.75% lower bound −1.05 mg/cm³; noninferiority
- Significant decrease in total hip trabecular volumetric bone mineral density (vBMD) in all groups
- −1.2% to −1.9%
Secondary outcomes
Weight loss · 12 months
- Similar significant WL in all groups
- 9.0% to 11.2%
Adherence · 12 months
- Mean (SD) self-reported vest wear time
- 7.1 (1.5) h/d
- Mean (SD) lost weight replaced in vest
- 78.0% (29.9%)
- WL+RT mean (SD) sessions attended
- 71.4% (19.1%)
Original publication
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