REVIEWWeight strategy in older adults with obesity: calorie restriction or not?Colleluori, Georgiaa; Villareal, Dennis T.b,c Author Information aDepartment of Experimental and Clinical Medicine, Center for the Study of Obesity, Marche Polytechnic University, Ancona, Italy bDivision of Diabetes, Endocrinology, and Metabolism, Baylor College of Medicine cCenter for Translational Research on Inflammatory Diseases, Michael E. DeBakey VA Medical Center, Houston, Texas, USA Correspondence to Dennis T. Villareal, MD, Baylor College of Medicine, Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd, Houston, 77030 TX, USA. Tel: +1 713 794 7156; e-mail: [email protected] Current Opinion in Clinical Nutrition and Metabolic Care: September 20, 2022 - Volume - Issue - 10.1097/MCO.0000000000000879 doi: 10.1097/MCO.0000000000000879 Buy PAP Metrics Abstract Purpose of review Along with the marked increase in the population of older adults with obesity is the need for effective strategies to treat aging- and obesity-related complications. This review highlights recent progress in obesity management in older adults. Recent findings Although calorie restriction is needed to significantly reduce fat mass, an exercise protocol is crucial to ameliorate functional outcomes. The addition of a resistance exercise protocol improves the response of muscle protein synthesis to anabolic stimuli, preventing the calorie restriction-induced reduction in muscle and bone mass. The addition of an aerobic exercise protocol improves cardiorespiratory fitness and cognitive function. However, the addition of both aerobic and resistance exercise protocols to calorie restriction provides the greatest improvements in myocellular quality, frailty, and cardiometabolic and cognitive outcomes, translating into the greatest improvement in quality of life. Such comprehensive lifestyle intervention effectively improves glucometabolic control and age-relevant outcomes in older adults with diabetes. When combined with testosterone therapy, such lifestyle intervention also preserves muscle and bone mass in older, men with obesity and hypogonadism. Summary We conclude that calorie restriction among older adults with obesity should be prescribed in combination with both aerobic and resistance exercise to maximize benefits on overall health. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.