Obesity in old age

Many older people in developed countries are overweight or obese. The prevalence is increasing as more people reach old age already overweight. Obesity in old age is associated with increased morbidity and a reduction in quality of life. The relative increase in mortality is less in older than young adults and the body weight associated with maximal survival increases with advancing age. Although intentional weight loss by overweight older people is probably safe and beneficial, caution should be exercised in recommending weight loss to overweight older people on the basis of body weight alone. Methods of achieving weight loss in older adults are the same as in younger adults. Weight loss diets should be combined with an exercise program to preserve muscle mass, as dieting results in loss of muscle as well as fat, and older people have reduced skeletal muscle mass in any case. Weight loss drugs have not been extensively studied in older people, and there is the potential for drug side effects and interactions. Weight loss surgery appears to be safe and effective, albeit slightly less so than in younger adults, but little is known about the outcomes of such surgery in those over 65 years.