Obesity in the Older Adult

Obesity in the Older Adult - #66

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Dealing with obesity in the older population in an out-patient setting.

Patient with obesity and secondary health consequences in the outpatient setting.

Review obesity related key concepts for an older person and provide recommendations for proper caloric intake and physical activity towards modest intentional weight loss, better health and quality of life.

  1. Recognize the prevalence of obesity in older adults and negative consequences in all four geriatric domains.

  2. Explain the Obesity Paradox, and the role of proper nutrition and exercise.

  3. Recognize the benefits of modest weight loss in older adults with obesity towards the prevention and management of obesity-related complications and other chronic diseases.

  1. Valencia WM, Stoutenberg M, Florez H. Weight loss and physical activity for disease prevention in obese older adults: an important role for lifestyle management. Curr Diab Rep. 2014, 14(10); 539-548.

  2. Hainer V, Aldhoon-Hainerová I. Obesity paradox does exist. Diabetes Care. 2013; 36 Suppl 2: S276–S281.

  3. Carnethon MR, De Chavez PJD, Biggs ML, et al. Association of weight status with mortality in adults with incident diabetes. JAMA, 2012; 308: 581-590.

  4. Flegal KM, Kit BK, Orpana H, Graubard BI. Association of all-cause mortality with overweight and obesity using standard body mass index categories. A systematic review and meta-analysis. JAMA. 2013; 309: 71-82.

  5. Tobias DK, Pan A, Jackson CL, et al. Body-mass index and mortality among adults with incident type 2 diabetes. N Engl J Med. 2014; 370: 233-244.

  6. Lavie CJ, McAuley PA, Church TS, Milani RV, Blair SN. Obesity and cardiovascular diseases: implications regarding fitness, fatness, and severity in the obesity paradox. J Am Coll Cardiol. 2014; 63:1345-1354.

  7. McAuley PA, Beavers KM. Contribution of cardiorespiratory fitness to the obesity paradox. Prog Cardiovasc Dis. 2014; 56: 434-440.

  8. Barry VW, Baruth M, Beets MW, Durstine JL, Liu J. Blair SN. Fitness vs fatness on all-cause mortality: a meta-analysis. Prog Cardiovasc Dis. 2014; 56: 382-390.

  9. Banack HR, Kaufman JS. The obesity paradox: understanding the effect of obesity on mortality among individuals with cardiovascular disease. Prev Med. 2014; 62: 96-102.

  10. Batsis JA, Mckenzie TA, Barre LK, Lopez-Jimenez F, Bartels SJ. Sarcopenia, sarcopenic obesity and mortality in older adults: Results from the National Health and Nutrition Survey III. Eur J Clin Nutr 2014; 68: 1001-1007.

  11. Basu S, Seligman H, Winkleby M. A metabolic-epidemiological microsimulation model to estimate the changes in energy intake and physical activity necessary to meet the Health People 2020 obesity objective. Am J Public Health, 2014; 104:1209-1216.

  12. Tuomilehto J, Lindström J, Eriksson JG, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001; 344:1343-1350.

  13. KnowlerWC, Barrett-Connor E, Flowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle interventions or metformin. N Engl J Med. 2002; 346: 393-403.

  14. Wing RR, Hamman RF, Bray GA, et al. Achieving weight and activity goals among diabetes prevention program lifestyle participants. Obes Res. 2004; 12: 1426-1434.

  15. Kirkman SM, Briscoe VJ, Clark N, et al. Diabetes in older adults: A consensus report of the American Diabetes Association and the American Geriatrics Society. J Am Geriatr Soc 2012; 60(12): 2342-2356.

  16. Korytkowski MT. Lessons from the look action for health in diabetes study. Indian J Endocrinol Metab. 2013;17 suppl 3:S650–3.

  17. Pahor M, Guralnik JM, Ambrosius, WT, et al. Effect of structured physical activity on prevention of major disability in older adults. The LIFE study randomized clinical trial. JAMA 2014; 311: 2387-2396.

  18. Bouchonville MF, Villareal DT. Sarcopenic obesity – how do we treat it? Curr Opin Endocrinol Diabetes Obes 2013; 20: 412-419.

  19. Porter Starr KN, McDonald SR, Bales CW. Obesity and physical frailty in older adults: A scoping review of intervention trials. J Am Med Dir Assoc 2014; 15: 240-250.

This GFF ___ my competence in geriatrics.

Willy Marcos Valencia, MD

Physician Scientist

Director, Miami VA Metabolic Clinic

Miami VA Medical Center, Geriatrics Research, Education and Clinical Center (GRECC)

Voluntary Assistant Professor, Division of Epidemiology

University of Miami Miller School of Medicine – Department of Public Health Sciences