Many older people in developed countries are overweight or obese. The prevalence is increasing as
more people reach old age already overweight. Obesity in old age is associated with increased morbidity
and a reduction in quality of life. The relative increase in mortality is less in older than young adults
and the body weight associated with maximal survival increases with advancing age. Although intentional
weight loss by overweight older people is probably safe and beneficial, caution should be exercised
in recommending weight loss to overweight older people on the basis of body weight alone.
Methods of achieving weight loss in older adults are the same as in younger adults. Weight loss diets
should be combined with an exercise program to preserve muscle mass, as dieting results in loss of muscle
as well as fat, and older people have reduced skeletal muscle mass in any case. Weight loss drugs
have not been extensively studied in older people, and there is the potential for drug side effects and
interactions. Weight loss surgery appears to be safe and effective, albeit slightly less so than in younger
adults, but little is known about the outcomes of such surgery in those over 65 years.
