Fighting excess weight in old age: it’s not so simple

The issues of dealing with obesity in old age remain the subject of discussions, which often do not fall into the field of view of the media and articles on the topic of health due to the non-obviousness of the problem. After all, what could be wrong with losing weight? However, after 65 years, it carries certain risks that cannot be ignored. Let’s figure it out.

Why is losing weight in old age a special issue?

The issue of obesity and weight loss in old age contains a kind of “logical trap”. On the one hand, being overweight is bad for your health, and diet and exercise can be beneficial. On the other hand, some evidence suggests that being overweight may have protective effects on health. In addition, losing weight can be accompanied by loss of muscle mass and decreased bone density. After all, weight loss in old age can be a dangerous symptom.

These features are the cause of debate among scientists and the source of myths among physicians and non-specialists.

Losing weight in old age can be dangerous?

Weight loss can be inexplicable or deliberate. Inexplicable happens without the desire of people and without active action on their part. She really tied from dangers for health: primarily with an increased risk of death.

In this post, we focus on deliberate weight loss: to achieve it, people work, exercise and diet. The consequences of this weight loss are usually beneficial.


The standard criterion for obesity is a body mass index (BMI) over 30 kg / m2. To determine it, the weight in kilograms is divided by the height in meters, squared (BMI = m / h2).

In old age, BMI becomes an unreliable indicator. This is due to a large loss of mass due to muscles, their replacement with adipose tissue, age-related decrease in growth. Because of this, a person with a normal BMI may have a high percentage of body fat.

Abdominal (central) obesity (excess fat deposition in the abdomen) may be a more informative indicator of health risks. for instance, a waist circumference of more than 102 centimeters for men and more than 88 for women indicates a high risk of developing metabolic syndrome.

Does being overweight really have a protective effect?

The obesity paradox is a factor in which some doctors may be wary of recommending weight loss to older adults. This is a hypothesis based on several studies. According to her, obesity can protect people of age from death and the complications of certain chronic diseases. The paradox is that obesity is an important factor in the development and severe course of the same diseases.

Some research demonstratedthat the risk of death in older people decreases as BMI increases. This effect was found, in particular, for mortality from heart failure, stroke… Weight loss has been linked to increased risk by scientists hip fracture.

Studies that inspire fear of losing weight usually have a common flaw: they do not consider the cause of weight loss… She can be associated primarily with unwanted, involuntary weight loss. The usually short duration of observation of the elderly can also affect the accuracy of the results of such works.

The obesity paradox can hardly be projected onto intentional weight loss. Nevertheless, before losing weight in old age, you need to consult with a good specialist.

What harm can obesity do in old age?

The obesity paradox remains a subject of scientific debate, and the harmful effects of obesity on older people are well known.

Obesity and / or abdominal obesity are associated with:

Death risk associated with increased BMI is growing up to 75 years old. Scientists are not sure why for people older than this age the logic “the more weight, the higher the probability of death” does not work. there is assumptionthat most of the people who are most susceptible to the complications of obesity do not live to see these years.

High body fat can predict disability risk, and obesity connected with a decrease in the quality of life.

What exactly is known about the benefits of losing weight in old age?

Weight loss programs improve the health of the elderly. Here are examples of studies in which scientists analyzed their effects.

Heart disease, metabolism

Several studies (1, 2, 3) scientists have shown the effectiveness of aerobic exercise programs (150 minutes per week) and a low-calorie diet for people aged 60-79 years with heart disease and metabolic syndrome. After 18 months, participants noted:

  • weight loss and an increase in lean body mass, a drop in the level of markers of obesity and inflammation in the blood;
  • decrease in blood pressure;
  • improved indicators of markers of diabetes and heart disease in the blood.

The more severe the pathology was in the participants, the more expressive was the benefit of losing weight. The potential for consolidating these results can lead to a decrease in the risk of disability and mortality.

For hypertensive patients who have voluntarily lost weight, decreased the need for medicines to lower blood pressure.

Quality of life, mobility

In 2013, American scientists published the results of three studies on the effectiveness of various exercises and a low-calorie diet. According to their data, after 4-18 months, participants aged 50-79 did not lose weight, their mobility increased, they began to walk faster and became more independent.

Another study showedthat exercise (3 sessions of 90 minutes a week) and weight loss improve the condition of older people with mild to moderate manifestations of senile asthenia (decrepitude).


Weight loss after a special program led to relieve pain in patients who simultaneously suffered from knee osteoarthritis and obesity. They became easier to move, became more independent.

But after all, there are side effects to deliberate weight loss?

Loss of muscle tissue

Even with arbitrary weight loss in old age, there are several potential risks. One of the biggest concerns is the loss of lean mass, primarily muscle mass. On her may accrue up to a quarter of the weight lost.

The danger of sarcopenia (a decrease in the quantity and quality of muscle mass) during weight loss can be “bypassed”. The most effective means of counteracting it is strength exercises: with dumbbells, body weight, expander… They not only strengthen muscles, but also help get rid of excess fat (1, 2). Other types of exercise – for example aerobic and their combination with power – also help prevent sarcopenia.

Sarcopenia and obesity connected with a diet: the first develops with inadequate nutrition, the second – due to excessive energy consumption. To select the right diet, you need to consult with a specialist. It should be low in calories, but contain adequate amounts of protein and micronutriens (vitamins and minerals).

Bone loss

Weight loss in old age is often accompanied by a decrease in bone density (osteopenia). Bone disorders increase the risk of fractures.

In a new review looking at bone health in old age, scientists indicatethat decreased bone density is more often associated with involuntary weight loss. The desired weight loss through diet and exercise can also negatively affect bones. But this effect, according to experts, is relatively small. Combining a low-calorie diet with exercise can help maintain bone health almost at the same level as before you lost weight.

Seniors May Need Help

Losing those extra pounds and maintaining a healthy weight requires dietary changes and continued activity. It can be difficult for the elderly to change their lifestyle due to illness, decreased quality of life, depression, and cognitive impairment. Their physical activity can decline due to disability and muscle weakness. Loneliness and social isolation can pose additional challenges.

Older people often need help from family members or professionals. Specialist help is desirable because most of the available weight loss programs calculated to younger people.



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