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However, the association between changes in body composition with intentional weight loss and physical function over the long-term is unknown. Thus, we examined the association between changes in body composition and physical function 8 years following an intensive lifestyle intervention (ILI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Subjects\/Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a secondary analysis of participants at the Baton Rouge site within the Look AHEAD study. Participants (n\u2009=\u2009220) were middle-aged and older adults with overweight\/obesity and T2DM randomized to an ILI or diabetes support and education (DSE). Body composition was measured by dual-energy X-ray absorptiometry at baseline and Year 8. Physical performance (expanded Short Physical Performance Battery [SPPB\n                      <jats:sub>exp<\/jats:sub>\n                      ], 20- and 400-m walk) and strength (grip and knee extensor) were assessed at Year 8.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Percent change (mean\u2009\u00b1\u2009SD) from baseline in weight, fat and lean mass over 8 years were \u22124.0\u2009\u00b1\u20097.3%, 0.2\u2009\u00b1\u200912.5% and \u22126.5\u2009\u00b1\u20095.3% in ILI and \u22123.0\u2009\u00b1\u20099.7%, 1.2\u2009\u00b1\u200917.1% and \u22125.8\u2009\u00b1\u20096.6% in DSE, respectively. ILI had better SPPB\n                      <jats:sub>exp<\/jats:sub>\n                      scores and faster gait speed than DSE at 8-year follow-up (p\u2009&lt;\u20090.05). Increases in fat mass were associated with worse SPPB\n                      <jats:sub>exp<\/jats:sub>\n                      scores in ILI and DSE (p\u2009=\u20090.03) and with slower gait speed in DSE (p\u2009=\u20090.01). Decreases in lean mass were associated with weaker grip strength in ILI (p\u2009=\u20090.04) and knee extensor strength in ILI and DSE (p\u2009&lt;\u20090.05). There were no significant interactions by intervention group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although the overall intervention effect on physical function was positive, increases in fat mass were associated with poorer physical performance while lean mass loss was associated with weaker strength 8 years post-randomization. Findings highlight the importance of minimizing fat mass gain\/regain and loss of lean mass during intentional weight loss.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s41366-025-01997-x","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T12:45:19Z","timestamp":1766493919000},"page":"760-767","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Long-term change in body composition following intentional weight loss and its effect on physical function"],"prefix":"10.1038","volume":"50","author":[{"given":"Kacey","family":"Chae","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyan","family":"Leng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca H.","family":"Neiberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9945-8772","authenticated-orcid":false,"given":"George A.","family":"Bray","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3493-4077","authenticated-orcid":false,"given":"Karen C.","family":"Johnson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James O.","family":"Hill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6800-9368","authenticated-orcid":false,"given":"John M.","family":"Jakicic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5633-8973","authenticated-orcid":false,"given":"Ariana M.","family":"Chao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen M.","family":"Beavers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry J.","family":"Pownall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen B.","family":"Kritchevsky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise K.","family":"Houston","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the Look AHEAD Movement and Memory Ancillary Study Research Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,23]]},"reference":[{"key":"1997_CR1","unstructured":"Hales CM, Carroll MD, Fryar CD, Ogden CL. 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