Obesity: changing the face of geriatric care

Statistics suggest that more and more older Americans are carrying extra weight-an estimated 40% of individuals between the ages of 60 and 69 have a body mass index >30 and 30% of persons between ages of 70 and 79 years are obese. Obesity, coupled with the challenges of aging, leads to an unfortunate burden of chronic disease, functional decline, poor quality of life, and an increased risk of being homebound. Physical assessment of the elderly obese patient should include measurement of height, weight (to determine body mass index) and waist circumference (to address central obesity) and consideration of vascular, skin, and mobility issues. Weight management strategies such as diet and hydration should balance nutritional requirements with weight loss; particular attention to protein needs in chair- and bedbound patients is necessary. Additional approaches such as exercise, bariatric weight loss surgery, and weight loss medication should be considered on an individual basis related to their inherent risks in this population. Weight loss/management options framed from an interdisciplinary perspective can improve quality of life for these patients and their caregivers. Research specific to obesity in this age group is warranted.