[Obesity in the elderly: clinical relevance and therapy options]

The prevalence of obesity is increasing, also in the elderly population. During advancing age in adulthood body weight continues to increase up to peak values at about 65 years of age followed by a decline in older age. Overweight and obesity are related to an increase in the cardiometabolic risk, but also to an increased incidence of degenerative joint disease, functional limitations, and immobility. An increase in mortality risk was demonstrated for BMI values > 30 kg/m(2), which are in the range of obesity. It is therefore suggested to consider weight reduction in obese elderly primarily with respect to weight-related comorbidities and functional limitations that may benefit from weight loss. The central aim of weight loss in the obese elderly is to improve quality of life. Nutritional recommendations combined with individually adapted exercise programs are helpful to prevent malnutrition, sarcopenia, and osteoporosis. No data are available about the safety of drug therapy for weight reduction in the elderly.