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Body weight and weight change and their health implications for the elderly
Abstract
After the age of 60 y, body weight on average tends to decrease. The contribution of fat mass to this weight loss is relatively small, but fat tends to be redistributed with advancing age toward more abdominal (particularly visceral) fat. Anthropometric data are relatively poor indicators of these aging processes. This may be one of the explanations why the relationship between high body mass index and mortality is less pronounced in older than in younger people. Reduced lipolysis in the visceral fat depot with aging is among potential explanations why increased visceral fat seems to be less harmful in elderly subjects compared to young adults. Even though the relative contribution of increased fat mass to mortality may be less pronounced in elderly people, the impact on disability and functional limitations is found to be important from both a clinical and a public health point of view. At the other end of the scale studies have shown that low body mass index and weight loss in the elderly are both strong predictors of subsequent mortality. This cannot be explained by effects of smoking and early mortality after baseline. There are only few systematic studies comparing the predictive validity of different anthropometric data for mortality. One recent prospective study showed that a high waist circumference (in nonsmoking men) may be a better predictor of all-cause mortality than high body mass index and waist/hip ratio. Low BMI was a better predictor of mortality than low waist circumference. In conclusion changes in body composition and fat distribution with aging are poorly captured by standard anthropometric data. Low lean body mass is probably better reflected by low BMI, whereas increased (abdominal) fatness is better reflected by increased waist circumference.
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“Unintentional weight loss, more likely driven by comorbid disease, excessively impacts metabolically active tissue over fat mass [45].”
From Obesity pharmacotherapy in older adults: a narrative review of evidence (2025) · cites this paper as [45]
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Loginova, T. P., Есева, Т. В., & Bojko, E. R. (2019) · Advances in Gerontology · doi:10.1134/s2079057019020139
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“, 2003) ↓ (Seidell and Visscher, 2000) NS (St-Onge and Gallagher, 2010) ↑ (Mancuso and Bouchard, 2019; Tchkonia et al.”
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de Pontes, T. L. (2020) · doi:10.11606/d.17.2020.tde-04012021-115729
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“Seidell and Visscher (2000) indicate an unintentional decline in body weight and BMI among the elderly, usually in the seventh and eighth decades and overweight and obesity reach maximal rates among middle-aged adults.”
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Lan, N. T. N., Nga, T. T. T., Thao, T. P., et al. (2024) · Tạp chí Nghiên cứu Y học · doi:10.52852/tcncyh.v177i4e14.2365
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Fakhoury, H. M. A., Nassereddine, M., Tamim, H., Memish, Z. A., Elahi, M. A., Daher, S., & Hajeer, A. H. (2025) · Frontiers in Surgery · doi:10.3389/fsurg.2025.1531104
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Parker, K. (2010) · doi:10.15368/theses.2010.155
“The discrepancy is due to a significant increase in mortality at lower BMIs that is often observed in the elderly, possibly due to its reflection of low lean body mass (Seidell & Visscher 2000).”
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Dai, H., Zhang, Z., Zhu, L., Lin, H., & Xia, X. (2026) · Biomedical Signal Processing and Control · doi:10.1016/j.bspc.2026.110200
GUIDELINES FOR THE NUTRITIONAL MANAGEMENT OF BARIATRIC SURGERY PATIENTS: PRE- AND POST-OPERATIVELY
Kreider, R. (2010) · D-Scholarship@Pitt (University of Pittsburgh)
Metadata
- Authors
- Seidell, J., & Visscher, T.
- Affiliations
- National Institute for Public Health and the Environment (NL)
- Venue
- European Journal of Clinical Nutrition
- Published
- 2000-06-01
- Volume
- 54
- Issue
- S3
- Pages
- S33-S39
- ISSN
- 0954-3007 (ISSN-L)
- 1476-5640
- OpenAlex
- W2027647230
- Cited by
- 324
- References
- 0
- Citations by year
- 2026: 2 · 2025: 11 · 2024: 12 · 2023: 10 · 2022: 13 · 2021: 18 · 2020: 16 · 2019: 11 · 2018: 7 · 2017: 8 · 2016: 9 · 2015: 16 · 2014: 15 · 2013: 12 · 2012: 12
- FWCI
- 4.74
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- VU Research Portal (submittedVersion)
- Rivm (National Institute for Public Health and the Environment) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Nutrition and Health in Aging
- Health Sciences › Medicine › Physiology (medical) › Body Composition Measurement Techniques
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- body weight, weight loss, aging, older adults, visceral fat, abdominal fat distribution, body mass index, waist circumference, anthropometric indicators, mortality prediction, low body mass index, lean body mass, body composition, functional disability, lipolysis
- MeSH terms
- Adipose Tissue, Aged, Aging, Anthropometry, Body Composition, Body Constitution, Body Weight, Cross-Sectional Studies, Health Status, Humans, Mortality, Viscera, Body Mass Index
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