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Obesity in the elderly

L Romayne Kurukulasuriya and Damascene S Kurukulasuriya

The prevalence of obesity is increasing in all age groups, including the elderly. Obesity is associated with serious medical complications. In addition, obesity in the elderly can accelerate age-related decline in physical function. Intentional weight loss in the elderly is associated with significant improvements in quality of life, physical function and medical complications associated with obesity. At the same time, weight loss in the elderly is a controversial issue due to some of the health hazards associated with it, such as reduced bone density and fractures. Treatment modalities include lifestyle interventions, pharmacotherapy and surgery, with lifestyle interventions appearing to be the best method of management for the elderly, owing to the increased risks associated with other methods and perhaps as a result of inadequate data. Strength or resistance training rather than endurance exercise may be better in the elderly in whom loss of muscle mass and weakness are prominent deficits. Weight loss therapy that minimizes muscle and bone loss should be encouraged in obese elderly patients who have medical conditions associated with obesity and who have functional impairment and/or loss of quality of life owing to obesity.