Weight Struggles Common for Senior Adults

When it comes to weight and maintaining one's health, we've heard it countless times--eat less and exercise more. But most of the specific information we hear is aimed at younger adults. While the basics of managing weight still apply to senior adults, they tend to gain weight for different reasons and in different ways. And, because many chronic illnesses develop in old age, it can be especially important to avoid being overweight--and especially obese--as we approach the senior years.

Treating and preventing obesity in children routinely gains press attention. But some of the studies also show a significant number of senior adults are overweight, including many who are obese. According to a study conducted by the Journal of American Medicine in 2010, about 70 percent of adults over the age of 60 are overweight or obese. This condition puts them at high risk for developing diabetes and many other diseases.

What causes senior adults to get overweight or obese?

• As muscle mass decreases over time, fat mass increases. Studies show that a high percentage of fat mass in older adults increases the risks of disability, mobility limitations and decreased physical function.
• Many seniors simply continue to eat the same amount of food as they did when they were younger even though they're less active. That makes it easy for older adults to gain weight without changing anything else.
• Hormonal changes that occur as we age contribute to weight management. For example, we develop a resistance to leptin, a protein hormone that regulates energy intake and expenditure. It's also believed that aging plays a role in reduced responsiveness to thyroid hormone. These hormonal changes in senior adults can contribute to an increase in fat mass. 
• A change in metabolism in older adults contributes to quicker weight gain and slower weight loss. As we age, our digestive systems work less efficiently, which means less energy from food is burned off as calories while more is stored as fat.
• According to a journal article by Ann Mabe Newman, DSN, APRN, CNE published by the American Nursing Association, there are genetic factors that play a role in senior adult obesity. It's believed certain genotypes produce a different sensitivity to changes in body fat after over-eating. 
• According to the same journal article, our environment contributes to the chances of putting on weight as we age. Some seniors have less access to exercise and fitness centers, especially those who can offer specialized weight and physical activity programs. Seniors need safe places to walk and bike, and they aren't always readily available.
• One of the biggest lifestyle factors that lead to obesity in seniors is our society's growing habit of eating out. Studies show that when we eat out, we consume both more food and more food higher in fat that when we cook our meals at home. 

Why is it more dangerous for seniors to be overweight or obese?

According to the American Journal for Clinical Nutrition, while weight-related chronic diseases lead to high rates of mortality in people of all ages, the risk of dying from weight-related disease increases as people age. Additionally, it's proven that older adults who struggle with obesity also have higher rates of depression, especially those aged 60-74.

The lungs of obese patients decrease in size, making it easier to develop respiratory problems. Because, as we grow older, we naturally lose about 20 percent of our skin's dermal thickness, older adults who are overweight and obese can develop pressure sores much more easily.

Being overweight or obese as a senior adult can cause and/or exacerbate serious conditions such as type-two diabetes, cardiovascular disease and osteoporosis. 

For all these reasons, some studies show over-weight and obese senior adults are more likely to need nursing home care.

What should seniors do to avoid obesity?

The facts about seniors with obesity are scary. But, unlike many signs of getting older like wrinkles and greying hair, avoiding obesity is controllable. Even though genetics play a role in our weight and our ability to lose it, there are a variety of things older adults can do to maintain a healthy weight.

• If you or your loved one is struggling with weight as they get older, you should focus on not only modifications to eating and exercise, but also developing community support with others committed to maintaining a healthy weight. 
• Routine physical activity, even in the very old or frail elderly is shown to help avoid obesity and its related chronic illnesses. Older adults who struggle with weight should focus on physical activity designed to preserve muscle and bone mass. Both the American Society for Nutrition and the North American Association for the Study of Obesity recommend routine physical activity that includes stretching, aerobics and strengthening exercises.
• Talk with your doctor about the effects of your prescription drugs on weight management, and get advice on the best way to address it.
• Believe it or not, getting enough sleep helps you burn more calories. Because of certain hormonal changes that occur when you don't get enough sleep, you crave more food but feel less full. A lack of sleep also contributes to sleep-deprivation, and that leads to craving high-energy foods, which are often sweet or salty.
• Protein leads to healthy muscle development, but if certain sources of protein, such as meat, are harder to eat, focus on other, softer sources of protein like yogurt or eggs.
• Consult a dietician or your doctor before losing weight. For a number of reasons, diets that are recommended for younger adults can be dangerous and counter-productive in older adults. Don't rely on weight-management tips you used when you were younger unless your doctor says it's OK.
• If long exercise sessions are too much, adjust your physical fitness activity to short intervals throughout the day. For example, you can gain as much physical benefit from three 10-minute exercise sessions than one for a total of 30 minutes.

^{References:
Centers for Disease Control and Prevention Data Brief Number 106, published September 2012
"How much physical activity do older adults need?" published by the Centers for Disease Control and Management, cdc.gov, September 2013.
"Older Adults and Obesity--is Dieting the Answer?" by Lindsey Getz for Today's Dietician, Volume 15, No. 8, page 44.
"Weight Loss After 40: Why It's So Hard--and What Works," by Melanie Haiken, Senior Editor, Caring.com.
"Obesity in Older Adults," by Ann Mabe Newman, DSN, APRN, CNF for The Online Journal of Issues in Nursing, Volume 14, No. 1, Manuscript 3.
"How to Prevent Obesity," by the editors of StanfordHospital.org on behalf of Stanford Hospital & Clinics}