Obesity in the elderly--a future matter of concern?

In most studies mean body weight increases with age up to about age 60 and then levels off, but information about the association between body weight and mortality at higher ages is sparse, since most studies published are cross-sectional, thus introducing a bias in selectivity. Some studies actually suggest a protective effect of overweight in the oldest age groups. Indices of visceral obesity may be better indicators of risk than body mass index (BMI) in these age groups. Not only actual weight, but also weight development over the last decades may predict outcome. Most clinical trials exclude older patients and little is known about benefits of diets or drugs inducing weight loss in these age groups. More information is available suggesting multiple benefits of physical activity. Mechanical complications of obesity, such as osteoarthritis and static respiratory complications seem to improve with weight loss even at higher ages. For health economic reasons it will become important to address treatment strategies in the elderly in the future, since they will constitute a large segment of the population. Recent studies suggest that bariatric surgery, previously considered contraindicated in obese patients above age 60 can be safely performed even in patients above age 70 and with the same benefits as for younger subjects.