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Intentional weight loss in older adults: useful or wasting disease generating strategy?

Darmon, Patrice

Current Opinion in Clinical Nutrition & Metabolic Care: May 2013 - Volume 16 - Issue 3 - p 284–289
doi: 10.1097/MCO.0b013e32835f503f
TRANSLATIONAL RESEARCH IN WASTING DISEASES: Edited by Vickie E. Baracos, Didier Attaix and Claude Pichard

Purpose of review Strategies for weight management in older adults remain controversial as overweight may protect them against mortality whereas weight loss may have harmful effects by promoting sarcopenia and bone loss. It has been suggested that weight management for obese older adults should focus more on maintaining weight and improving physical function than promoting weight loss. This review aims to specify whether intentional weight loss in older adults is a useful or a wasting disease generating strategy.

Recent findings Recent randomized controlled studies have shown that a supervised, moderate caloric restriction coupled with regular exercise (both aerobic and resistance) in obese older adults do not increase mortality risk and may conversely reduce insulin resistance, metabolic complications, and disabilities without exacerbating lean mass and bone mineral density loss.

Summary In obese older adults, moderate weight loss may have beneficial effects on comorbidities, functional performances, and quality of life provided that regular physical activity can be associated. An individual approach considering life expectancy, chronic comorbidities, functional status, personal motivation, and social support should be preferred. More research is needed to define the circumstances in which cautious dietary restrictions are reasonably justified in older adults. In any case, in the oldest (≥80 years) as in frail individuals, it seems reasonable to abstain from recommending weight loss.

aDepartment of Nutrition, Metabolic Diseases and Endocrinology, Sainte-Marguerite University Hospital

bINRA UMR1260/INSERM UMR1062, ‘Nutrition, Obesity and Risk of Thrombosis’, Aix-Marseille University, Marseille, France

Correspondence to Patrice Darmon, MD, PhD, Sainte-Marguerite University Hospital, 270, boulevard de Sainte-Marguerite, F-13009, Marseille, France. Tel: +33 491745500; fax: +33 491745503; e-mail: patrice.darmon@ap-hm.fr

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.