{"id":7554,"date":"2024-02-14T08:05:15","date_gmt":"2024-02-14T13:05:15","guid":{"rendered":"https:\/\/www.silvercentury.org\/?p=7554"},"modified":"2024-02-14T08:05:15","modified_gmt":"2024-02-14T13:05:15","slug":"in-later-life-is-a-little-excess-weight-such-a-bad-thing","status":"publish","type":"post","link":"http:\/\/78.142.243.82\/~silvercentury\/2024\/02\/in-later-life-is-a-little-excess-weight-such-a-bad-thing\/","title":{"rendered":"In Later Life, Is a Little Excess Weight Such a Bad Thing?"},"content":{"rendered":"

As new weight-loss drugs with a high degree of success become available, journalist Judith Graham considers whether older people really need to shed some of the pounds they\u2019ve gained as they\u2019ve aged. Some experts suggest that being slightly overweight may actually be good for a person\u2019s health in later life. Graham\u2019s article was posted on the <\/span><\/i>KFF Health News<\/span><\/a> website on July 17, 2023. It also ran on <\/span><\/i>CNN<\/a>.<\/span><\/i> Funding from the Silver Century Foundation helps <\/span><\/i>KFF Health News<\/span> develop articles (like this one) on longevity and related health and social issues.<\/span><\/i> <\/span><\/i><\/p>\n

Millions of people enter later life carrying an extra 10 to 15 pounds, weight they\u2019ve gained after having children, developing joint problems, becoming less active or making meals the center of their social lives.<\/span><\/p>\n

Should they lose this modest extra weight to optimize their health? This question has come to the fore with a new category of diabetes and weight loss drugs giving people hope they can shed excess pounds.<\/span><\/p>\n

For years, experts have debated what to advise older adults in this situation. On one hand, weight gain is associated with the accumulation of fat. And that can have serious adverse health consequences, contributing to heart disease, diabetes, arthritis and a host of other medical conditions.<\/span><\/p>\n

On the other hand, numerous studies suggest that carrying some extra weight can sometimes be protective in later life. For people who fall, fat can serve as padding, guarding against fractures. And for people who become seriously ill with conditions such as cancer or advanced kidney disease, that padding can be a source of energy, helping them tolerate demanding therapies.<\/span><\/p>\n

Of course, it depends on how heavy someone is to begin with. People who are already obese (with a body mass index of 30 or over) and who put on extra pounds are at greater risk than those who weigh less. And rapid weight gain in later life is always a cause for concern.<\/span><\/p>\n

Making sense of scientific evidence and expert opinion surrounding weight issues in older adults isn\u2019t easy. Here\u2019s what I learned from reviewing dozens of studies and talking with nearly two dozen obesity physicians and researchers.<\/span><\/p>\n

Our bodies change with age.<\/b> As we grow older, our body composition changes. We lose muscle mass\u2014a process that starts in our 30s and accelerates in our 60s and beyond\u2014and gain fat. This is true even when our weight remains constant.<\/span><\/p>\n

Also, less fat accumulates under the skin while more is distributed within the middle of the body. This abdominal fat is associated with inflammation and insulin resistance and a higher risk of cardiovascular disease, diabetes and stroke, among other medical conditions.<\/span><\/p>\n

\u201cThe distribution of fat plays a major role in determining how deleterious added weight in the form of fat is,\u201d said Mitchell Lazar, MD, director of the Institute for Diabetes, Obesity and Metabolism at the University of Pennsylvania\u2019s Perelman School of Medicine. \u201cIt\u2019s visceral [abdominal] fat [around the waist], rather than peripheral fat [in the hips and buttocks] that we\u2019re really concerned about.\u201d<\/span><\/p>\n

Activity levels diminish with age.<\/b> Also, with advancing age, people tend to become less active. When older adults maintain the same eating habits (energy intake) while cutting back on activity (energy expenditure), they\u2019re going to gain weight.<\/span><\/p>\n

According to the Centers for Disease Control and Prevention, 27 percent of 65- to 74-year-olds are physically inactive outside of work; that rises to 35 percent for people 75 or older. For older adults, the health agency recommends at least 150 minutes a week of moderately intense activity, such as brisk walking, as well as muscle-strengthening activities such as lifting weights at least twice weekly. Only 27 to 44 percent of older adults meet these guidelines, according to various surveys.<\/span><\/p>\n

Concerns about muscle mass.<\/b> Experts are more concerned about a lack of activity in older adults who are overweight or mildly obese (a body mass index in the low 30s) than about weight loss. With minimal or no activity, muscle mass deteriorates and strength decreases, which \u201craises the risk of developing a disability or a functional impairment\u201d that can interfere with independence, said John Batsis, MD, an obesity researcher and associate professor of medicine at the University of North Carolina School of Medicine in Chapel Hill.<\/span><\/p>\n

Weight loss contributes to inadequate muscle mass insofar as muscle is lost along with fat. For every pound shed, 25 percent comes from muscle and 75 percent from fat, on average.<\/span><\/p>\n

Since older adults have less muscle to begin with, \u201cif they want to lose weight, they need to be willing at the same time to increase physical activity.\u201d said Anne Newman, MD, director of the Center for Aging and Population Health at the University of Pittsburgh School of Public Health.<\/span><\/p>\n

Ideal body weight may be higher.<\/b> Epidemiologic research suggests that the ideal <\/span>body mass index (BMI)<\/span><\/a> might be higher for older adults than younger adults. (BMI is a measure of a person\u2019s weight, in kilograms or pounds, divided by the square of their height, in meters or feet.)<\/span><\/p>\n

One large, well-regarded study found that older adults at either end of the BMI spectrum\u2014those with low BMIs (under 22) and those with high BMIs (over 33)\u2014were at greater risk of dying earlier than those with BMIs in the middle range (22 to 32.9).<\/span><\/p>\n

Older adults with the lowest risk of earlier deaths had BMIs of 27 to 27.9. According to <\/span>World Health Organization standards<\/span><\/a>, this falls in the \u201coverweight\u201d range (25 to 29.9) and above the \u201chealthy weight\u201d BMI range (18.5 to 24.9). Also, many older adults whom the study found to be at highest mortality risk\u2014those with BMIs under 22\u2014would be classified as having \u201chealthy weight\u201d by the WHO.<\/span><\/p>\n

The study\u2019s conclusion: \u201cThe WHO healthy weight range may not be suitable for older adults.\u201d Instead, being overweight may be beneficial for older adults, while being notably thin can be problematic, contributing to the potential for frailty.<\/span><\/p>\n

Indeed, an optimal BMI for older adults may be in the range of 24 to 29, Carl Lavie, MD, a well-known obesity researcher, suggested in a separate study reviewing the evidence surrounding obesity in older adults. Lavie is the medical director of cardiac rehabilitation and prevention at Ochsner Health, a large health care system based in New Orleans, and author of <\/span>The Obesity Paradox<\/span><\/i>, a book that explores weight issues in older adults.<\/span><\/p>\n

Expert recommendations.<\/b> Obesity physicians and researchers offered several important recommendations during our conversations:<\/span><\/p>\n