A two-year lifestyle programme for older adults in German family-doctor practices improved what participants ate and how active they were, but left their body weight no different from that of people who received general advice. The finding, from a new analysis of the AgeWell.de trial in 678 adults aged 60 to 77 with overweight or obesity, is a reminder that a better diet and more activity reported on paper do not always show up on the scales, even over 24 months and in people who say they want to lose weight.
What the analysis measured
AgeWell.de was a cluster-randomised trial, meaning whole practices rather than individual patients were assigned to the programme or to the comparison. It was designed to protect thinking and memory in people at raised risk of dementia, not to produce weight loss. The programme bundled dietary counselling, encouragement to be more physically, socially and mentally active, a review of medicines, management of cardiovascular risk factors and, where needed, support for depressive symptoms or grief.
This analysis, which the authors describe as post hoc, looked only at participants with a body-mass index of 25 or more. Their average age was 68.9 and 52% were women. After adjusting for other factors, and using statistical imputation to fill gaps in the data, assignment to the programme was not associated with body weight at 24 months: the estimated difference was 0.30 lower in the programme group, with a 95% confidence interval from 0.51 lower to 1.11 higher. That interval includes zero, so the trial found no measurable effect. The abstract does not state the unit, though body weight is ordinarily modelled in kilograms.
Participants in both groups reported high motivation and confidence about losing weight at the start, and those levels held steady throughout, whichever group they were in. The strongest predictor of weight at two years was weight at the start.
How it fits
Earlier this month this site covered a children’s programme run through Boys & Girls Clubs that moved BMI scores without changing what the children drank. AgeWell.de points the other way: the behaviours shifted and the weight did not. Neither result says lifestyle change is pointless. Diet quality and physical activity carry benefits of their own, and AgeWell.de was aimed at the brain, not the waistline. What it does show is that, in this programme, the changes participants made were not large enough to move their weight over two years.
What is not yet known
Because the analysis was not planned in advance and the trial was not designed or powered for weight, a small real effect could have been missed. The reported confidence interval is not centred on the estimate, which the abstract does not explain, and the full text was not available to us to check it. The participants were older adults at risk of dementia in Germany, so the result may not carry over to younger people or to programmes with weight loss as their explicit target.
Sources: Zülke AE, Schultz A, Luppa M, et al. Body weight following a multidomain lifestyle intervention in older adults at risk of dementia: a post-hoc analysis of the AgeWell.de-trial. BMC Geriatrics, 15 October 2026 (doi: 10.1186/s12877-026-08492-6; trial registration DRKS00013555).
