Treatment of obesity in older persons—A systematic review
Abstract
Summary: The study aims to systematically review the available evidence regarding weight loss interventions (lifestyle, surgical, and pharmacological) for obesity in adults aged over 60 years. A search of prospective, randomized studies took place in January 2018, on Medline (Web of Science) and PubMed databases. Search terms included the following: elderly, obese, hypocaloric, pharmacotherapy, and bariatric surgery. Abstracts were screened for eligibility. A total of 256 publications regarding lifestyle interventions were identified; of these, 69 studies were eligible. As no eligible studies were identified for pharmacotherapy or bariatric surgery, the search was broadened to include non‐ randomized studies. Four pharmacotherapy and 66 surgery studies were included. Lifestyle intervention had similar weight loss efficacy in older compared with younger people, with positive effects on a number of relevant outcomes, including physical function and cardiovascular parameters. There was little data regarding obesity pharmacotherapy in older persons. The available data for bariatric surgery indicate comparable weight loss and resolution of type 2 diabetes, with similar or slightly higher complication rates in older compared with younger people. Older age alone should not be considered a contraindication to intensive lifestyle or surgical intervention for obesity. There are insufficient data to guide clinical decisions regarding obesity pharmacotherapy in older people.
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Traditional lifestyle modification typically induces a mean 5-10% reduction in baseline weight at 1 year, compared with 1-2% for controls.
“in contrast to 5–10% for lifestyle modification”
From The Role of Lifestyle Modification with Second-Generation Anti-obesity Medications: Comparisons, Questions, and Clinical Opportunities (2023) · cites this paper as [22]
Muscle mass is more likely preserved during intentional weight loss, but is reduced during unintentional weight loss.
“Concomitantly, muscle mass is more likely preserved during intentional weight loss, but is reduced during unintentional weight loss [50].”
From Obesity pharmacotherapy in older adults: a narrative review of evidence (2025) · cites this paper as [50]
Every one kilogram reduction in body weight is associated with a decrease in bone mineral density of 0.1% at the femoral neck.
“Every one kilogram reduction in body weight is associated with a decrease in bone mineral density of 0.1% at the femoral neck [50].”
From Obesity pharmacotherapy in older adults: a narrative review of evidence (2025) · cites this paper as [50]
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“After a follow up of 18 months, two studies have demonstrated weight regain of 40% to 65% of initial weight loss, and this regain was made up of body fat.(86,87) However, one of these studies(86) also followed up physical function, and found that despite weight regain, physical function improvements were maintained.”
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- Authors
- Haywood, C., & Sumithran, P.
- Affiliations
- The University of Melbourne (AU)
- Corresponding author
- Sumithran, Priya
- Venue
- Obesity Reviews
- Publisher
- Wiley
- Published
- 2019-01-15
- Volume
- 20
- Issue
- 4
- Pages
- 588-598
- ISSN
- 1467-7881 (ISSN-L)
- 1467-789X
- OpenAlex
- W2910039492
- Cited by
- 84
- References
- 150
- Citations by year
- 2026: 4 · 2025: 11 · 2024: 18 · 2023: 9 · 2022: 15 · 2021: 11 · 2020: 13 · 2019: 3
- FWCI
- 2.16
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Obesity Reviews (publishedVersion)
- PubMed (publishedVersion)
- Minerva Access (University of Melbourne) (submittedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- obesity, older adults, weight loss interventions, lifestyle intervention, bariatric surgery, obesity pharmacotherapy, type 2 diabetes remission, physical function, cardiovascular outcomes, weight loss efficacy
- MeSH terms
- Aged, Aged, 80 and over, Diet, Reducing, Humans, Life Style, Middle Aged, Obesity, Weight Loss, Exercise, Bariatric Surgery
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