[Management of obesity in older adults : challenges, specificities, and therapeutic strategies]

Obesity in older adults is a growing public health concern. Age-related changes in body composition, including loss of muscle mass, fat redistribution, and reduced basal metabolism, promote sarcopenia and sarcopenic obesity, thereby limiting the relevance of body mass index as a sole risk indicator. While weight loss can improve certain cardiometabolic and functional outcomes, it poses specific risks in older adults, particularly worsening sarcopenia, malnutrition, frailty, and loss of independence. Obesity management should therefore be individualized and focused on preserving physical function and quality of life, with adapted nutritional strategies, physical activity, and behavioral interventions as the cornerstone of care.