A new study out of the Cleveland Clinic found that obesity robs us of more years of our lives than any other preventable health issue. That means that of all the top lifestyle-related killers that are in our power to modify or treat — including smoking, high blood pressure and high cholesterol — obesity shortens life the most.
That is bad news for the 13 million adults aged 65 and over who are obese, which is more than a third of that age group. While a few extra pounds on older adults are not a health issue and may even be beneficial, too much excess weight can contribute to a variety of health problems, including inflammation, diabetes, heart disease, stroke, certain cancers, joint problems and even cognitive impairment.
Additionally, obese older adults are admitted to the hospital and emergency room more than their non-obese counterparts.
While your weight or BMI may not change (with age), your body fat stores may increase — as well as your risk for obesity-related diseases.
The good news is that while obesity can lead to lost years or unhealthy years, you have the power to get those years back. Even losing as little as 3 percent of your total body weight can make a difference if you maintain it.
Who Is Considered Obese?
Usually, people who have a body mass index (BMI) of 30 or more are considered obese and those with a BMI between 25 and 29.9 are overweight. Your BMI is an estimate of your body fat based on height and weight.
However, there are other factors to consider in addition to, or instead of, your BMI.
Dr. Tiffany Lowe-Payne, a family practitioner in Raleigh, N.C., with a board certification in obesity medicine, says that defining obesity can be tricky for older adults.
With age, we tend to lose muscle mass, which weighs more than fat. So, while your weight or BMI may not change, your body fat stores may increase — as well as your risk for obesity-related diseases. On the other hand, older adults often lose inches in their height and may be classified as obese because their BMI has increased but their weight has stayed the same.
“You need to look at multiple factors. We look at waist circumference and waist-to-hip ratio,” explains Lowe-Payne. (Abdominal fat increases the risk for heart disease.) “We can track those measurements over time to see if patients have reduced their health risks even if the number on the scale is the same.”
Why Are Many Older Adults Obese?
Some adults have always had weight issues. Others find the number on the scale climbs as their metabolism and energy levels slow and their eating habits change — or perhaps, unwisely, don’t.
Lifestyle changes may be a factor as well. If you’re a widow or widower, you may not cook or visit the grocery store as frequently as in the past. Registered dietitian Maureen Janowski, a certified specialist in gerontological nutrition and fellow of The Academy of Nutrition and Dietetics explains that fear of falling or low energy levels may prevent older adults from shopping regularly for fresh produce and healthy food.
Instead, they may stock up on unhealthy processed foods that have a longer shelf life or resort to fast-food options. Additionally, medications for other health issues, such as heart disease and high blood pressure, may cause weight gain.
Lowe-Payne points out that menopause for women and declining testosterone levels for men can alter hormonal balances that can also contribute to weight gain.
The Obesity Paradox
While the health benefits of losing weight for younger people are clear cut, there is some debate in the medical community when it comes to excess weight in older adults. In some cases, obesity or some excess weight is thought to be protective.
“In some individuals, especially those with heart disease, we see that excess weight can stop them from having an acute cardiac episode,” says Lowe-Payne.
The problem is that losing weight leads to muscle loss. Older adults are already prone to losing muscle mass, a condition called sarcopenia. Low muscle tone can lead to falls, low energy and less activity. In fact, Janowski says that she doesn’t counsel her patients to lose weight unless they are very obese. “For overweight adults, I tell them to maintain their weight and stay active,” she says.
Excess weight can also be protective in the case of prolonged hospitalization or illness, which usually leads to weight and muscle loss. But the amount of excess weight that is helpful is still in question, says Lowe-Payne.
“We don’t know how much excess weight is beneficial and we also don’t know exactly why it’s beneficial,” she says.
How to Lose Weight Safely
Losing weight for older adults can be slightly more complicated than your basic “eat less, exercise more” formula. Lowe-Payne strongly advises working with a doctor to determine a safe and effective exercise and weight-loss plan. Additionally, a physician can review your medications to see if any may cause weight gain. Some general guidelines to help older people lose weight effectively and safely include:
Cardiovascular exercise The Centers for Disease Control and Prevention (CDC) recommends 150 minutes of moderate-intensity exercise every week. If you haven’t exercised before or in a while, it’s important to start slowly. It’s not necessary to strap on running shoes or grab a tennis racquet. Lowe-Payne says walking or even gardening can be beneficial.
Strength training It’s important to make sure that any weight-loss program includes strength training (at least twice a week, recommends the CDC) to prevent muscle loss. Again, no need to bench press dozens of pounds. Simple exercise bands or even lifting household items such as soup cans will have an effect, says Janowski.
Protein It’s essential for preserving and building muscles, and some research suggests that older adults need more protein than their younger counterparts. Try eating a serving of protein at every meal, including a yogurt or eggs for breakfast.
Hydration It’s important to stay hydrated for health reasons and also because thirst is sometimes confused with hunger. Drinking water all day long can help you feel fuller and prevent dehydration. You can jazz up your water by adding lemon, lime or another type of fruit for a boost of flavor.
Portion control A simple way to remember how much of each type of food you need per meal, or what constitutes a portion, is to use the U.S Department of Agriculture My Plate visual. Fill half your lunch or dinner plate with fruits and vegetables, a quarter with whole grains such as quinoa or brown rice and the other quarter with a lean protein. If you buy packaged goods, read the label so you understand the portion sizes.
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