Obesity in the elderly: More complicated than you think
Open accessAbstract
The number of obese older adults is on the rise, although we lack a proper definition of obesity in this age group. The ambiguity is primarily related to sarcopenia, the progressive loss of muscle and gain in fat that come with aging. Whether to treat and how to treat obesity in the elderly is controversial because of a paucity of established guidelines, but also because of the obesity paradox—ie, the apparently protective effect of obesity in this age group. Treatment of obesity in older adults is controversial because of inadequate guidelines and the obesity paradox, the apparently protective effect of obesity with age.
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Weight loss increases the risk of sarcopenia, frailty, functional decline, fractures, and malnutrition.
“and consequently increases the risk of sarcopenia, frailty, functional decline, fractures, and malnutrition (276, 282, 283).”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [282]
The “CETIN AND NASR” section says intentional weight loss also reduces skeletal muscle, and “SARCOPENIA: LOSS OF MUSCLE WITH AGE” links muscle loss to frailty and loss of physical function. But Table 2 lists improved physical function with intentional weight loss, while the treatment discussion names protection from fractures as a potential benefit. The paper does not establish that weight loss increases fracture or malnutrition risk. (LLM, conf=0.88)
Experimental — accuracy not yet measuredWeight loss, whether intentional or not, enhances the age-related loss of muscle mass.
“Further, weight loss, whether intentional or not, enhances the age-related loss of muscle mass”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [282]
The “CETIN AND NASR” section says intentional weight loss reduces skeletal muscle and that older patients have already lost muscle mass. “Intentional vs unintentional weight loss” reports a slight decline in lean body mass with intentional weight loss, but does not establish the same effect for unintentional weight loss. The “SARCOPENIA: LOSS OF MUSCLE WITH AGE” section distinguishes age-related muscle loss from wasting associated with involuntary weight loss. Page numbers are unavailable in our copy. (LLM, conf=0.83)
Experimental — accuracy not yet measuredCurrent expert recommendations regarding weight reduction in older people primarily refer to cases of obesity that are associated with comorbidities and obesity-related adverse health effects.
“Current expert recommendations regarding weight reduction in older people primarily refer to cases of obesity that are associated with comorbidities and obesity-related adverse health effects (276)(277)(278)282).”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [282]
Interventions working in young adults cannot simply be extrapolated to older populations with low muscle mass and frailty.
“Interventions working in young adults cannot simply be extrapolated to older populations with low muscle mass and frailty (282).”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [282]
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- Authors
- Cetin, D. C., & Nasr, G.
- Affiliations
- Cleveland Clinic (US)
- Case Western Reserve University (US)
- Venue
- Cleveland Clinic Journal of Medicine
- Publisher
- Cleveland Clinic Journal of Medicine
- Published
- 2014-01
- Volume
- 81
- Issue
- 1
- Pages
- 51-61
- ISSN
- 0891-1150 (ISSN-L)
- 1939-2869
- OpenAlex
- W2083578070
- Cited by
- 94
- References
- 79
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 7 · 2023: 8 · 2022: 15 · 2021: 10 · 2020: 11 · 2019: 11 · 2018: 6 · 2017: 2 · 2016: 4 · 2015: 12 · 2014: 5
- FWCI
- 0.90
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Cleveland Clinic Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- obesity in older adults, sarcopenia, obesity paradox, obesity treatment, aging, muscle mass loss, fat gain, obesity definition, treatment guidelines
- MeSH terms
- Aged, Diet, Humans, Life Style, Obesity, Quality of Life, Weight Loss, Body Mass Index, Practice Guidelines as Topic, Bariatric Surgery, Resistance Training, Waist Circumference, Sarcopenia
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