The weight loss of 16 obese patients (greater than 130% ideal body weight) who participated for three months in a comprehensive, multidisciplinary weight reduction program was studied. Patients were divided into two groups based on the reported time of onset of their obesity. Childhood-onset obesity was defined in this study as marked weight gain by the age of 11. Adult-onset obesity was defined as weight gain occurring at 18 years of age or later. Each group of patients consisted of two males and six females. The childhood-onset obesity group lost significantly more weight than the adult-onset obesity group during this three-month period (19.45 +/- 3.6% versus 16.17 +/- 2.8%). This preliminary study suggests that patients with childhood-onset obesity tend to lose more weight in a comprehensive multidisciplinary weight reduction program than patients with adult onset obesity.

One hundred two consecutively nutritionally supported patients were studied to determine the effect of age on the response to nutritional support and outcome of hospital stay. The patients were divided into two groups: group 1 (n = 37) consisted of all patients under 65 years of age, and group 2 (n = 65) consisted of patients 65 years of age and older. All patients underwent a complete nutritional assessment prior to the initiation of nutritional support and weekly thereafter. The patients' somatic compartments were assessed using weight, arm muscle circumference, creatinine height index, and triceps skinfold thickness. The visceral compartments were assessed using serum albumin level, transferrin total iron binding capacity (TIBC) level, and total lymphocyte count. Nitrogen balance was evaluated and cell-mediated immunity was determined using a standard battery of antigens. The patients' nutritional assessment parameters at the start of therapy were compared with those at discharge or death and correlated with outcome of hospital stay. The difference in crude mortality rates between the two groups was statistically significant; however, there was no significant difference between the type and degree of nutritional depletion and mean length of nutritional therapy between the two groups. There was also no significant difference between the degree of improvement or maintenance of somatic or visceral parameters, nitrogen balance, or cell-mediated immunity between the two groups. It is therefore concluded that age alone is not a deterrent to the use of aggressive nutritional support in the elderly.

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