What Causes Obesity in Elderly?
Obesity in the elderly can have far-reaching consequences on their future quality of life. Obesity will not only predispose you to chronic conditions but it can also increase your risks of limited movement, injury, permanent disability and the need for assisted living arrangements.
The rate of obesity in older adults has been increasing steadily with recent estimates in the U.S. showing that over one-third of adults over 60 are obese. However, the elderly can lose weight safely and successfully if it is managed correctly.
This article looks at the potential effects of obesity in older adults and the factors that contribute to the problem. We then discuss the best approaches to weight loss in the elderly and how you can prevent weight gain, which so often accompanies aging.
The Risks of Obesity in Elderly
The focus of this article is specifically on obesity in the elderly. It is interesting to note that while younger adults have a higher risk of disability or death if they are either overweight or obese, it appears that in older adults being somewhat overweight seems to have a protective effect.
What Is Obesity?
Obesity is defined by a body mass index (BMI) of 30 or more. BMI is calculated with a formula using a person’s height and weight, and though it does not always provide the complete picture, it is a useful screening tool widely used by health care professionals.
More recently attention has also focused on waist circumference as an indicator of high risk for disease in those who are overweight. Here, obesity is defined as a waist circumference of greater than 40 inches in males and 35 inches in females.
How Obesity Affects Seniors
Studies have found that people over 60 who are obese can expect fewer remaining years without a limitation in their activities of daily living compared to those who are not overweight.
It is well documented that obesity is one of the main contributors to the worldwide epidemic of non-infectious chronic diseases which causes high rates of disability and death. These conditions include type 2 diabetes, hypertension, heart disease, strokes and cancer.
Furthermore, obesity limits a person’s ability to move around and places stress on their joints. The elderly who are obese are also more prone to incidents, such as falling, which can cause long-term disability. They are also more likely to become seriously ill after an injury or if they contract an infectious disease. This has been clearly demonstrated during the COVID-19 pandemic.
Obesity also affects mental health. Mental ability (memory and thought processes) deteriorates more rapidly in those who are obese and they also have higher rates of depression.
Reasons Why the Elderly Gain Weight
We are all aware that being overweight, or being obese, is the result of consuming more calories than what we need for bodily functions and activities. The tendency to gain weight as we age is, however, somewhat more complex than eating the same amount while being more sedentary. There are a number of other complicating factors that should be considered:
- As we age we lose muscle mass and this is replaced by fat. This is a natural process, known as sarcopenia, which starts in our 30s and accelerates as we age. Inactivity increases the rate of this process.
- Our metabolic rate, the rate at which our body burns calories for energy, slows down as we age. This is directly linked to the extent of sarcopenia, as lean muscle mass determines metabolic rate.
- The hormonal and other biochemical changes that occur with aging contribute to weight gain. A recent study found that changes in how fat tissue is removed and stored changes with age, leading to weight gain irrespective of how much one eats or exercises.
- Genetics, which determines our individual body chemistry, can cause some people to be more prone to obesity than others.
- Many of the medications used to treat the chronic conditions in older adults might increase the risk of weight gain.
- Physical inactivity during and after hospitalization for an illness or injury, for example a hip replacement, often triggers excessive weight gain.
- Not getting enough sleep due to insomnia can lead to craving energy-rich foods and can also affect the repair and rebuilding of muscle tissue that takes place while we sleep.
- The growing habit of ordering take-outs or eating out more frequently is contributing to obesity, as one tends to eat more, and these foods are usually higher in calories than home-cooked meals.
Weight Management for Seniors
Successful weight loss in the elderly is possible and significant gains can be achieved when obese older adults lose even as little as 3% of their body weight. Weight reduction in the elderly does however require more careful management than in younger adults and should ideally be done under supervision of a medical practitioner.
Avoid Strict Diets
Diets with strict calorie and protein restriction are dangerous for older adults. The most successful weight loss programs are those that involve lifestyle changes, including a healthier diet and exercise.
Maintain Muscle Mass
Any intentional weight loss leads not only to reduction in fat but also in muscle mass and this is a significant consideration in any weight loss program for the elderly. Weight loss should not increase sarcopenia or cause loss of bone tissue.
Adopt Healthy Eating Habits
The best approach to weight loss, at any stage in life, is to adopt healthy eating habits. This implies a balanced diet that includes plenty of fruit and vegetables, healthy fats and sufficient protein while restricting sugar and carbohydrates. A dietician can be consulted to help an older person work out an eating plan with foods that are enjoyable, convenient and affordable.
There have recently been a number of studies reporting successful weight loss results in the elderly with high fat, low carbohydrate diets. This includes the Mediterranean, ketogenic and similar diets, which are all based on healthier eating. A further important point is to include enough protein in the diet, which is something the elderly often tend to neglect. Protein is essential for building muscle and counteracting loss of muscle mass.
Weight Loss Programs
A weight loss program for the elderly must also include regular exercise to maintain and build muscle. This means that resistance training is needed at least twice a week in addition to aerobic activity such as walking or swimming.
Exercise should start slow and be increased gradually. A physical therapist can be consulted to work out a home exercise plan according to the fitness level and physical ability of the elderly person. Specific exercise routines for seniors, including exercises that can be done while seated, are also available on the internet.
Medical Treatment for Obesity
Physical Exams and Tests
When supervising a weight loss program, your medical practitioner will probably conduct an initial physical examination to assess whether a weight loss program will be safe. They can also conduct standard tests, which they can later determine whether the values have improved after dietary changes.
You can also ask your medical practitioner to assess whether any of your routine chronic medications are contributing to obesity. If this is the case, there might be a possibility of changing the prescription.
There are various FDA-approved prescription medications available to treat obesity. However, these are mostly not recommended for the elderly. Firstly, the medicines have usually not been extensively tested for use with older adults. Secondly, many elderly already take various medications for chronic conditions with which the weight loss medication could interact.
Bariatric surgery is an effective treatment for obesity, which has gained popularity in recent years. This treatment might be recommended by medical practitioners for older adults whose weight puts them at high risk of medical complications and who meet the selection criteria.
Preventing Obesity in Old Age
Changes in our bodies as we age do predispose us to weight gain. If we allow this to get out of control it could lead to obesity which will affect our quality of life, overall health and lifespan.
Weight loss in the elderly is possible. Ideally, however, we want to avoid getting to the point of having to try and lose weight once we reach an advanced age. There is nothing we can do about many of the physical changes we experience as we get older, such as our wrinkles, looser skin and graying hair. But weight gain is something that can be avoided.
Prevent weight gain or lose some excess weight by eating healthier, exercising for at least 30 minutes a day, five times a week and getting enough sleep. If you have not adopted healthier habits yet, now is the time – it is never too late to make a difference.