Obesity in the Context of Aging: Quality of Life Considerations

Abstract

The progressive increase in the prevalence of obesity and aging in the population is resulting in increased healthcare and disability spending. The burden of obesity is particularly relevant in old age, due to accumulating co-morbidities and changes in body composition. Sarcopenic obesity, a mix of over- and under-nutrition, causes frailty, disability, and problems in social and psychological areas, impacting overall health-related quality of life (HR-QOL). The relationship between obesity, aging, and HR-QOL is, however, much more complex than generally acknowledged and is difficult to disentangle. The impact of obesity on HR-QOL is particularly strong in young people, who are free of co-morbidities. It progressively attenuates, compared with the general population, with advancing age, when co-morbid conditions are diffusely present and reduce the perceived health status, independent of obesity. However, even this apparent 'obesity paradox' should not minimize the importance of obesity on HR-QOL, as other obesity-associated limitations and disabilities do impact HR-QOL in older age. A patient-centered approach aimed at reducing the disability and social isolation of advancing age is mandatory to improve HR-QOL in any class of obesity.

Obesity and the burden of health risks among the elderly in Ghana: A population study

“…The finding that the obese elderly population were 70% more likely to be diagnosed with arthritis has important implications. While this finding confirms previous associations between obesity and arthritis [ 7 , 79 ], it provides additional proof of obesity’s impact on physical functionality [ 5 ]. The relationship between elderly obesity and severe arthritis often operates in a vicious cycle: elderly obesity causes limited physical activity and declining energy expenditure, which in turn facilitate progressive weight gain [ 7 , 80 ].…”

Health‐related quality of life and fall risk associated with age‐related body composition changes; sarcopenia, obesity and sarcopenic obesity

“…5 Obesity is a major cause of inactivity, dependence, destructive metabolic changes and death. 6 The term sarcopenic obesity refers to a combination of sarcopenia and obesity. Both have some similar inflammatory pathways and may potentiate each other.…”

For a Step Change to Curb the Obesity Epidemic

“…Hruby and Hu [2] provide a review of the epidemiological characteristics and trends of the disease and its burden, e.g., in terms of prevalence of obesity, risk factors, morbidity, mortality, and economic costs. Corica et al [3] review evidence on the impact of obesity and age on quality of life, highlighting the lesser-studied effect of obesity on the elderly. Cawley et al [1] and Li et al [4] use different approaches and data sources to estimate the medical care costs (and savings) associated with weight/body mass index (BMI)-and potential weight loss-for patients with and without diabetes.…”

“…Notably, obesity accounts for 42.3, 30.9, 22.4, and 9.8 % of the increase in the number of cases of diabetes, heart disease, hypertension, and hyperlipidemia, respectively, in the past quarter century [5]. Finally, obesity has a large impact on patient wellness, productivity [12][13][14], and quality of life [2,3], and is associated with significant costs to healthcare payers and society [1,4,5,15].…”