Preserving What Matters: A Multimodal Approach to Maintaining Fat-Free Mass During Anti-Obesity Medication Based Weight Loss

Author

Sarah Gore, Valparaiso University

Date of Award

5-3-2025

Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Mackenzie Shireman

Abstract

Weight loss is often associated with reductions in fat-free mass (FFM), which can negatively impact metabolic rate, thermoregulation, bone density, functional capacity, and overall quality of life (Roth et al., 2022; Sedlmeier et al., 2021). This Evidence-Based Practice project aimed to reduce FFM loss in adults prescribed anti-obesity medications (AOMs) for weight management through a targeted, multimodal intervention. Twenty-two patients beginning AOM treatment at a family practice in northwest Indiana were invited to participate, with 19 consenting to enroll. Each participant received personalized guidance, including tailored calorie and protein intake goals to support a hypocaloric, high-protein diet, alongside evidence-based aerobic and resistance exercise recommendations. A smartphone application, MyFitnessPal™, was used to promote diet and exercise adherence. Key metrics, including weight, body mass index, body fat percentage, and FFM, were measured at baseline and reassessed at four, eight, and 12 weeks. The primary outcome, FFM, was evaluated using a repeated-measures ANOVA, which revealed a significant effect of time on FFM, F(1.413, 19.781) = 5.047, p = 0.026. The moderate effect size (η² = 0.265) suggests that time accounted for 26.5% of the variance in FFM. Pairwise comparisons showed no significant differences between FFM at baseline and four weeks (p = 0.400), or four weeks and eight weeks (p = 0.258), but a significant decrease was observed between eight and 12 weeks (p = 0.002). These findings suggest that, despite the intervention, FFM was not fully preserved over the 12-week period, with a notable decline occurring after eight weeks. This project offers valuable insights into the effects of AOMs on body composition and highlights the challenge of preserving FFM. The findings provide important guidance for developing future interventions designed to improve preservation of FFM in individuals prescribed AOMs for weight management.

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Recommended Citation

Gore, Sarah, "Preserving What Matters: A Multimodal Approach to Maintaining Fat-Free Mass During Anti-Obesity Medication Based Weight Loss" (2025). Evidence-Based Practice Project Reports. 211.
https://scholar.valpo.edu/ebpr/211