Obesity in older adults: technical review and position statement of the American Society for Nutrition and NAASO, The Obesity Society

Abstract

Obesity causes serious medical complications and impairs quality of life. Moreover, in older persons, obesity can exacerbate the age-related decline in physical function and lead to frailty. However, appropriate treatment for obesity in older persons is controversial because of the reduction in relative health risks associated with increasing body mass index and the concern that weight loss could have potential harmful effects in the older population. This joint position statement from the American Society for Nutrition and the NAASO, The Obesity Society reviews the clinical issues related to obesity in older persons and provides health professionals with appropriate weight-management guidelines for obese older patients. The current data show that weight-loss therapy improves physical function, quality of life, and the medical complications associated with obesity in older persons. Therefore, weight-loss therapy that minimizes muscle and bone losses is recommended for older persons who are obese and who have functional impairments or medical complications that can benefit from weight loss.

Changes in intake of protein foods, carbohydrate amount and quality, and long-term weight change: results from 3 prospective cohorts

“…Aging can alter body composition, thereby reducing the correlation between increased BMI and excess adiposity (30). Using waist circumference, rather than BMI (or body weight), in an older population would more adequately reflect adiposity (31); however, we did not have 4-y repeated measures of waist circumference in the NHS, NHS II, and HPFS cohorts.…”

Management of Diabetes in the Elderly

“…Frequent communications or visits may be needed. 67,68 Blood Pressure Control Blood pressure should be measured at each medical visit, and goals and medications reevaluated. Home blood pressure monitoring may be helpful.…”

Balance and walking speed predict subsequent 8-year mortality independently of current and intermediate events in well-functioning women aged 75 years and older

“…Interestingly, Lang et al demonstrated recently in non-institutionalized men and women aged 65 years or older followed for 5 years that excess body weight had stronger associations with impaired physical function than with mortality (43). The lower effect on mortality of excess body weight in older people than in younger adults might be due at least in part to a survival bias, older obese people being also possibly those who are resilient to some noxious effects of excess body weight (43,44).…”