Weight Loss Never Ends: Weight Gain in the Elderly
Losing weight may be more important as we age than we thought. Older people have the same obesity problems as the young. Increasing medical problems of many make the treatment even harder. Often the problems are simply ignored.
Normal Body Weight Increases and then Decrease:
There is a general increase in body weight and body mass index (BMI) with age, until approx 60 years of age, when body weight and BMI begin to decline. The usual increase is about 1 lb. per year. This is associated with a loss of muscle mass and bone mass of at least ½ lb. per year as well. Its well documented that its the fat deposited inside of the abdomen around the vital organs that is associated with all of the complications of obesity. Unfortunately as we all age the proportion of intra-abdominal fat, which is related to increased morbidity and mortality, progressively increases.
Decline in Food Intake and Exercise with Age:
Unlike younger people, there is a progressive decline in both food intake and energy expenditure with age. However in many older people the reduction in exercise is not met by the same amount of decrease in food intake resulting in weight gain. All of energy intake and daily total energy expenditure (165 kcal/decade in men and 103 kcal/decade) in women is primarily due to a decrease in both physical activity, and in basal metabolic rate.
Medical Problems Associated with Aging Limits Activity:
Complicating these matters is that physical activity can be even more impaired by the many problems of aging-arthritis especially in the back, ankles, feet and knees, heart disease brought on by high cholesterol, diabetes or arteriosclerosis and pulmonary problems like asthma and emphysema all limit the ability to perform physical activity.
Benefit of Weight Loss:
Weight loss in the elderly can reduce disability from arthritis, diabetes and other conditions, reduce cardiovascular risk factors, and improve well-being. Reduction in BMI is a good predictor as well as waist circumference. A 10 lb. weight loss is associated with a decrease in waist circumference of 2 inches and a decrease in overall mortality of 17%, Furthermore, increased physical activity in the elderly, which is an important component of weight management, can produce beneficial effects on muscle strength, endurance, and well-being.
Arthritis Benefits: Take for example arthritis of the knees, a 10 lb. weight gain is associated with an increase in 40 lbs. on the knees. In the lower spine, the factor of overall weight gain to increase spinal pressure may be as great as a factor of 1 lb. weight gain = 10 lb. increase spinal pressure.
Diabetes Benefits: Weight gain around the abdomen is directly related to elevated blood sugar. Whether the engorged fat cells secret anti-insulin factors or inactive circulating insulin, the result is increasing insulin resistance as one increases waist line. Losing as little as 15 lb. can reduce elevated blood sugar by 50%!
Hypertension Benefits: Like diabetes there is a direct correlation between increase waist circumference as it reflects intra-abdominal fat deposition and diastolic blood pressure. Lose weight and decrease blood pressure by 10- 15 mm Hg.
Heart Disease: Again fat cells are involved directly with damage to the heart and to cardiac and peripheral arteries. Even modest weight loss can reverse many of these problems.
Small Weight Loss = Big Benefits:
Weight loss, even as little as 10 -15 lb is associated with an improvement in metabolic parameters such as blood sugar, triglycerides, blood pressure and cholesterol and a marked marked improvement in arthritic pain especially the critical areas: feet, knees and back. These are the areas where arthritis can limit activity and thus contribute to even more weight gain and disability.