Strength changes, induced by very low-calorie diet (VLCD, 520 kcal/day) alone and in combination with exercise, were determined in 109 severely obese females (46.8±4.69% fat). Experimental treatments included VLCD alone (LC, n = 40), VLCD with endurance exercise (EE, n = 23), VLCD with endurance exercise and resistance strength training (EERST, n = 23), and VLCD with resistance strength training (RST, n = 23). All subjects participated in the study for 90 days while EE, EERST, and RST exercised four times/week according to specified schedules. Results indicated significant differences for the change scores (baseline to 90 days) for bench press, knee flexion, upper body and lower body composite strength scores between RST and all other groups. RST was the only treatment that increased upper and lower body strength. No differences between groups were found for body mass losses, decreases in percent fat and fat mass. In contrast, these variables showed significant change scores for all groups. Decreases in fat-free mass (FFM) were 5.18±3.40 kg, 4.79±4.15 kg (p = 0.001), 4.64±4.23 kg, and 3.26±2.67 kg for EE, LC, RST, and EERST, respectively. These data suggest that the combination of resistance strength training and VLCD increases strength despite a loss of FFM. However, endurance exercise and VLCD do not seem to affect body mass loss or FFM lossper se.Moreover, it seems that these increases in strength may represent a training effect which might imply improved central neuromuscular function rather than muscular hypertrophy since FFM decreased in all groups.