Oral Presentation ESA-SRB-ANZOS 2025 in conjunction with ENSA

Gaining Strength While Losing Weight: Functional Improvements During a Very Low Energy Diet (128303)

William Beningfield 1 2 , Andrea Cawte 2 3 , Helen d'Emden 2 3 , Caitlin Merz 2 4 , Scott Ruddell 2 5 , Keren Singh 2 , Matthew Seymour 2 6 , Abby Yu 2 4 , Gemma Woodruff 2 4 , Robin Hay 2 3 , Helen MacLaughlin 2 3 7
  1. Physiotherapy, Royal Brisbane & Women’s Hospital, Brisbane, QLD, Australia
  2. Tertiary Obesity Multidisciplinary Service, Royal Brisbane & Women’s Hospital, Brisbane, QLD, Australia
  3. Nutrition Research Collaborative, , Royal Brisbane & Women’s Hospital, Brisbane, QLD, Australia
  4. Pharmacy Department, Royal Brisbane & Women’s Hospital, Brisbane, QLD, Australia
  5. Psychology Department, Royal Brisbane & Women’s Hospital, Brisbane, QLD, Australia
  6. Endocrinology Department, Royal Brisbane & Women’s Hospital, Brisbane, QLD, Australia
  7. Queensland University of Technology, School of Exercise and Nutrition Sciences, Brisbane, QLD, Australia

Very Low Energy Diets (VLEDs) are commonly used in tertiary obesity care to achieve rapid weight loss. However, there are concerns around the potential for muscle mass loss and reduced functional capacity. This study aimed to determine whether individuals undertaking a 12-week VLED could improve strength and endurance when supported by a physiotherapist-led exercise program within a multidisciplinary team (MDT) framework.


Forty-four participants (mean baseline BMI = 45.4 kg/m²) from the Tertiary Obesity Multidisciplinary Service (TOMS) at the Royal Brisbane and Women’s Hospital were reviewed during the 2024–2025 period. Participants completed a 12-week VLED alongside a structured exercise program, which included weekly one-hour physiotherapy-led strength classes using gym equipment, therabands, and free weights. A home exercise prescription of two days of cardiovascular activity and three days of strength training was also provided. Functional outcomes were assessed at baseline and week 12 using grip strength (kg/f), the 6-minute walk test (6MWT, metres), and 30-second sit-to-stand (STS, repetitions). Body weight and BMI were recorded pre- and post-intervention.


Participants lost an average of 12.6 kg (SD 4.3, p<0.001) and a mean BMI reduction of 4.5 kg/m². Grip strength improved from 32.1 kg to 37.8 kg (mean difference +5.7 kg, p<0.001), exceeding the ≥5 kg threshold for clinical significance. The 6MWT distance increased from 385.8m to 494.1m (mean difference +108.3 m, p<0.001), well above the ≥50m threshold for significance. STS repetitions rose from 11.7 to 16.9 (mean difference +5.2 reps, p<0.001), exceeding the ≥2 rep threshold.


Despite rapid weight loss, participants demonstrated clinically and statistically significant gains in functional capacity. These findings support incorporating physiotherapy-led resistance training into VLED programs to enhance outcomes and preserve strength during weight loss.

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