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Cited by 53Nutrition and Health in AgingObesity, Physical Activity, DietBody Composition Measurement Techniques

Challenges in the Management of Geriatric Obesity in High Risk Populations

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Porter Starr, Kathryn, McDonald, Shelley, Weidner, Julia, Bales, Connie·2016·Nutrients
DOI 10.3390/nu8050262PMC PMC4882675
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Abstract

The global prevalence of obesity in the older adult population is growing, an increasing concern in both the developed and developing countries of the world. The study of geriatric obesity and its management is a relatively new area of research, especially pertaining to those with elevated health risks. This review characterizes the state of science for this “fat and frail” population and identifies the many gaps in knowledge where future study is urgently needed. In community dwelling older adults, opportunities to improve both body weight and nutritional status are hampered by inadequate programs to identify and treat obesity, but where support programs exist, there are proven benefits. Nutritional status of the hospitalized older adult should be optimized to overcome the stressors of chronic disease, acute illness, and/or surgery. The least restrictive diets tailored to individual preferences while meeting each patient’s nutritional needs will facilitate the energy required for mobility, respiratory sufficiency, immunocompentence, and wound healing. Complications of care due to obesity in the nursing home setting, especially in those with advanced physical and mental disabilities, are becoming more ubiquitous; in almost all of these situations, weight stability is advocated, as some evidence links weight loss with increased mortality. High quality interdisciplinary studies in a variety of settings are needed to identify standards of care and effective treatments for the most vulnerable obese older adults.

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  • Obesity is an increasing problem in older people, currently affecting between 18 and 30% of the worldwide population aged 65 years and older.

    “obesity with its well-known negative health consequences is an increasing problem also in older people, currently affecting between 18 and 30% of the worldwide population aged 65 years and older (10,11).”

    From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [11]

    Section 1, “Overview of the Obesity Challenge in High-Risk Populations,” describes obesity as an increasing global challenge among older adults. It does not give an 18–30% prevalence for the worldwide population aged 65 and older; its figures concern U.S. adults aged 60 and older, other age groups, or a worldwide change in prevalence rather than current prevalence. (LLM, conf=0.90)

    Experimental — accuracy not yet measured

  • In cases of obesity with comorbidities, positive effects of intended weight loss on orthopedic problems, cardiovascular and metabolic risk, insulin sensitivity, chronic inflammation, and functional limitations have been reported, partly in combination with physical exercise.

    “In these cases, positive effects of intended weight loss on orthopedic problems, cardiovascular and metabolic risk, insulin sensitivity, chronic inflammation, and functional limitations have been reported, partly in combination with physical exercise (11,274,276,278,285,286).”

    From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [11]

    The Overview section (page unavailable) reports that planned, supervised weight reduction in obese older adults can improve type 2 diabetes, coronary heart disease, osteoarthritis symptoms, and physical function. It also describes weight reduction combined with exercise. The copy does not report improved insulin sensitivity or reduced chronic inflammation from weight loss; its discussion of inflammation concerns obesity’s contribution to a chronic inflammatory state. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Maintaining stable body weight is considered desirable for overweight older adults.

    “Therefore, and to avoid a progression to obesity, maintaining stable BW is considered desirable for overweight older adults (11).”

    From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [11]

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Cited by

Sorted by citations

Authors
Porter Starr, K., McDonald, S., Weidner, J., & Bales, C.
Affiliations
  • Department of Medicine, Duke University Medical Center, P.O. Box 3003, Durham, NC 27710, USA
  • Duke Medical Center (US)
ORCID
McDonald, Shelley
Venue
Nutrients
Publisher
MDPI AG
Published
2016-05-04
Volume
8
Issue
5
Pages
262
ISSN
2072-6643 (ISSN-L)
DOI
10.3390/nu8050262
PMC
PMC4882675
OpenAlex
W2346734764
Cited by
53
References
10
Citations by year
2026: 5 · 2025: 6 · 2024: 2 · 2023: 7 · 2022: 6 · 2021: 7 · 2020: 5 · 2019: 6 · 2018: 5 · 2017: 3 · 2015: 1
FWCI
0.55
Type
journal article
Language
en
Open access
Licence
Locations
  • Nutrients (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • DukeSpace (Duke University) (submittedVersion, cc-by-nc-nd)
Funders
NIA (AG0000029)
Topics
  • Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
Keywords
older adults, frailty, nutritional status, hospitalized older adults, nursing homes, weight management, weight loss, obesity management program, chronic disease, multidisciplinary care, weight stability
MeSH terms
Aged, Humans, Obesity, Risk Factors, Global Health, Weight Loss

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