Benefit-to-Risk Balance of Weight Loss Interventions in Older Adults with Obesity
Purpose of Review
Obesity in the older adult is a burgeoning health epidemic that leads to increased morbidity, disability, and institutionalization. This review presents a brief overview of geriatric-specific consequences of obesity by highlighting the risks and benefits of intentional weight loss.
Intentional weight loss reduces the extent of adiposity-related illnesses, yet the approach in older adults is fraught with challenges. Interventions combining caloric restriction and physical exercise (aerobic and resistance) maximize fat loss and minimize loss of muscle and bone. Interventions are also effective at improving physical function, reducing medication burden, and improving symptomatic osteoarthritis in this population. Approaches can mitigate the risks of isolated caloric restriction on muscle and bone in a safe and effective manner.
Effective weight loss strategies should be considered in older adults. While there are potential risks, practical clinical approaches can minimize the potential harms while maximizing their benefits.
KeywordsObesity Older adults Benefits Risks
Bone mineral density
Body mass index
Center for Medicare and Medicaid
Dr. Batsis receives funding from the National Institute on Aging of the National Institutes of Health under Award Number K23AG051681 and from the Friends of the Norris Cotton Cancer Center at Dartmouth and National Cancer Institute Cancer Center Support Grant 5P30 CA023108-37 Developmental Funds. Dr. Batsis also receives funding from the Patient Centered Oriented Research Institute. Support was also provided by the Department of Medicine and the Dartmouth Health Promotion and Disease Prevention Research Center supported by Cooperative Agreement Number U48DP005018 from the Centers for Disease Control and Prevention. The Dartmouth Clinical and Translational Science Institute, under award number UL1TR001086 from the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH), and by the National Institute for Drug Abuse P30DA029926.
Compliance with Ethical Standards
Conflict of Interest
Peter R. DiMilia and Alexander Mittman declare that they have no conflict of interest.
John A. Batsis received honoraria from the Royal College of Physicians of Ireland, Endocrine Society, and Dinse, Knapp, McAndrew LLC, legal firm. In addition, Dr. Batsis has a patent issued on Instrumented Resistance Exercise Device.
Human and Animal Rights and Informed Consent
This article does not contain any procedures with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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