New Category of Diabetes and Weight Loss Drugs Give Hope to Older Adults Struggling with Extra Weight
Millions of people in later life find themselves carrying an extra 10 to 15 pounds of weight, often gained after having children, developing joint problems, becoming less active, or making meals the center of their social lives. This weight gain can have serious health consequences, such as heart disease, diabetes, arthritis, and other medical conditions. However, recent developments in the field of diabetes and weight loss drugs have given people hope that they can shed these excess pounds.
For years, experts have debated whether older adults should strive to lose this modest extra weight. On one hand, weight gain is associated with the accumulation of fat, which can lead to adverse health outcomes. On the other hand, carrying some extra weight in later life has been found to be protective in certain situations. For example, extra fat can serve as padding, protecting against fractures in the event of a fall. It can also provide a source of energy for those undergoing demanding therapies for serious illnesses like cancer or advanced kidney disease.
To make sense of the complex scientific evidence and expert opinions surrounding weight issues in older adults, researchers reviewed dozens of studies and interviewed nearly two dozen obesity physicians and researchers. They found that as people age, their body composition changes, with muscle mass decreasing and fat increasing, even if overall weight remains constant. Additionally, more fat tends to accumulate in the abdominal area, leading to inflammation, insulin resistance, and a higher risk of cardiovascular disease, diabetes, and stroke.
Older adults also tend to become less active as they age, which can contribute to weight gain. The US Centers for Disease Control and Prevention recommends at least 150 minutes of moderately intense activity, such as brisk walking, per week for older adults to maintain their health. However, many seniors fail to meet these guidelines, with 27% of 65- to 74-year-olds and 35% of those aged 75 or older being physically inactive outside of work.
While weight loss is often recommended for overweight or mildly obese older adults, experts express concerns about maintaining muscle mass and overall muscle strength. Lack of activity and weight loss can lead to muscle deterioration, increasing the risk of disability and functional impairment. For every pound shed, 25% is muscle loss, while 75% is fat loss. This is particularly concerning for older adults who already have less muscle mass to begin with.
Epidemiologic research suggests that the ideal body mass index (BMI) for older adults might be higher than for younger adults. A large study found that older adults with BMIs in the middle range of 22 to 32.9 had the lowest risk of earlier death. Those with BMIs above 33 or below 22 were at greater risk. The study concluded that the World Health Organization’s healthy weight range may not be suitable for older adults. Instead, being overweight may have benefits for older adults, while being notably thin can contribute to frailty.
Based on their review of the evidence, obesity physicians and researchers offered several recommendations for older adults struggling with extra weight. They emphasized that maintaining fitness and muscle mass is more important than losing weight for overweight older adults. Unintentional weight loss should be investigated, as it can signal serious underlying illnesses. In terms of diet, maintaining diet quality and making sure to consume enough protein are essential. Weight loss may be more important for older adults with excess belly fat (apple shape) compared to those who carry more weight in their lower body (pear shape). Additionally, maintaining stability in weight for healthy older adults carrying extra weight is a good goal.
Overall, the decision to lose or maintain weight in later life should be based on individual circumstances and health considerations. Older adults should consult with their healthcare providers to determine the best course of action for their specific situation.
KFF Health News, a national newsroom producing in-depth journalism about health issues, reviewed the evidence and expert opinions on weight maintenance and weight loss in older adults. The findings provide valuable insights for those navigating the complexities of weight management in their later years.