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Treatment of obesity for the elderly must be multifaceted

For most older adults, effectively treating overweight and obesity can add years to their lifespan and quality to the years of life when they are healthy, according to a paper by the Gerontological Society of America (GSA).

Obesity rates for adults 65 years of age and older have nearly doubled from 22% in 1988 to 42% in 2020. The GSA aims to enhance the understanding among health care professionals, policy makers, and consumers of obesity as a disease and the need to intently treat individuals with obesity using guideline-based and standard-informed multidisciplinary and multifaceted plans of care.

Overweight and obesity are now recognised as chronic health conditions with specific pathophysiologic causes, with complications if these conditions are not addressed, and with treatments that are safe and effective.

In a new paper, ‘Insights & Implications in Gerontology: The Chronic Disease of Obesity’, the GSA calls attention to the steps included in its ‘Toolkit for the Management of Obesity in Older Adults’ and provides readers with insights into a variety of obesity care guidelines.

"Obesity was designated as a chronic disease by the American Medical Association several years ago," explained Dr John A Batsis, from the University of North Carolina at Chapel Hill, and co-author of the paper. "The challenge here is whether it really has been implemented and accepted as part of being a chronic disease by health care practitioners."

He also emphasized the importance of challenging common, biased beliefs about people living with obesity and enhancing the importance of obesity as a disease that needs to be managed accordingly, adding that obesity needs to be viewed along the lines of hypertension, diabetes, high cholesterol, and other comorbidities.

"We need to consider it as a chronic disease, not as a failure of behavioural management among patients across the entire lifespan," he said. "It's about biology. Everybody is an individual and with each chronic disease, it's a biological basis of what triggers the onset of the disease."

"We know that our older adults experience more social isolation than any other population, with over 50% of individuals 60 years of age an older being at risk for social isolation. We also know that social isolation may limit the nutrient density and amount of foods that are consumed,” added Dr Kathryn Porter Starr, from Duke University School of Medicine and Durham VA Medical Center, and co-author of the paper. “So, we may see someone who has obesity who is not actually getting all the nutrients that they need because they're eating alone and eating prepackaged meals.”

Porter Starr said the importance of involving a variety of professionals in the older adult's care team who can go beyond assessment of physiological and metabolic conditions to address social, environmental, and economic risk factors that often go unrecognised: "Transportation is another big issue that we don't always talk about and ask about. Do people have transportation to and from a grocery store? Do they have the ability to get groceries or carry the groceries? Do they have the ability to be able to prepare food?"

To access this paper, please click here


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