Getting older means it’s even more important to maintain a healthy weight. That’s because excess weight can lead to obesity—a chronic health condition that can have a big impact on our health and quality of life as we age.

The bright side: Today, there are more solutions than ever to help older adults manage their weight. Whether you’re looking to optimize your own health or support someone else, learning more about obesity—and how to lower your risks—is the first step toward a healthier you.

What is obesity?

According to the Obesity Medicine Association, obesity is “when a person’s body accumulates and stores excessive amounts of body fat.” Roughly 40% of American adults have obesity (100 million+ people), with higher rates among adults age 40 to 59.¹

In June 2013, the American Medical Association (AMA) officially recognized obesity as a disease state. This milestone helped pave the way for better research and obesity care options.

How is obesity diagnosed?

The most common way to measure obesity is through body mass index (BMI), which calculates weight in relation to height:

• A BMI of 25 to 29.9 falls into the overweight category.
• A BMI of 30 or higher is classified as obesity.

While BMI is a useful screening tool, it doesn’t tell the whole story. Muscle mass, bone density, and fat distribution also play a role in determining whether excess weight poses health risks. That’s why it’s important to get a complete evaluation of your health beyond just the numbers.

What are the health impacts of obesity for older adults?

Carrying extra weight can contribute to serious health issues, including:

• Higher risk of chronic diseases: Obesity is linked to conditions such as type 2 diabetes, heart disease, high blood pressure, gallbladder disease, stroke, and certain types of cancer. People with obesity are also more likely to have severe complications due to COVID.
• Joint and mobility issues: Excess weight puts strain on our joints, increasing the risk of osteoarthritis and making daily movement more difficult. This can lead to less physical activity, which in turn makes weight management more challenging.
• Lower levels of independence: Obesity can affect our balance, flexibility, and strength, which hinders our ability to move around and do things for ourselves. Research has linked obesity in older adults with lower muscle quality and strength as well as reduced functional performance, balance, walking speed, and aerobic capacity.² One study showed that obesity boosts the risk of falls—a leading cause of injury and loss of independence for older people.³

• Sleep and breathing problems: Conditions like asthma and sleep apnea are more common in people with obesity. Poor sleep can lead to fatigue and memory problems as well as weight gain.
• Mental health and well-being: Many older adults with obesity struggle with poor body image and self-esteem, which can affect their confidence and emotional wellness. This may increase the risk for mental health conditions like depression and anxiety.

What are the risk factors for obesity?

According to the Centers for Disease Control and Prevention (CDC), there are a range risk factors for obesity:

• Unhealthy lifestyle behaviors: Poor eating habits, like consuming too much sugar and processed foods and too little fruits and vegetables, can set the stage for obesity. Lack of regular physical activity and persistent poor sleep can also make weight gain more likely.
• Stress: Chronic stress raises cortisol levels, which heightens our appetite and cravings for unhealthy foods.
• Certain medical conditions: Health disorders like Cushing’s syndrome and hypothyroidism can slow metabolism.
• Genetics: Increasingly, research suggests obesity has a genetic link. Our genes can impact everything from how we metabolize nutrients to how our bodies store fat. Inherited disorders like Bardet-Biedl syndrome can raise obesity risk by affecting metabolism and appetite control.
• Environment: When older Americans have less access to healthy foods, safe exercise spaces, and quality health care, it can make weight management more challenging.

While these are general risk factors for obesity, aging can cause changes in our bodies that also make us more inclined to put on weight.  

Why do we gain weight with age?

Sometimes it’s obvious why we’ve packed on a few pounds. Maybe we’re snacking too much or not moving enough. But weight can creep on as we get older—even if we’re not changing our behaviors.

Several factors make weight gain more common with age:

• Muscle loss: Aging is linked with muscle loss and decreased muscle mass and strength (sarcopenia). Smaller muscles burn fewer calories when we’re at rest.
• Slower metabolism: Metabolism is our body’s natural calorie-burning “furnace.” When it’s less efficient, we burn fewer calories, making it easier to gain weight. “Your metabolism tends to slow down as you get older,” said National Institutes of Health (NIH) aging expert Dr. Rafael de Cabo in an NIH newsletter. “But your appetite and your food intake do not. So, you have a steady increase of body weight with age.”
• Hormonal changes: Age-related shifts in hormones, such as lower testosterone in men and reduced estrogen in women, can lead to weight gain.
• Sleep disturbances: In one recent study, 39% of older adults age 45 to 64 reported not getting enough sleep.⁴ Poor sleep can impact the hormones that regulate our appetite.
• Medications: Older people are more likely to take medications to manage various health conditions. Some of these may promote weight gain by interfering with our body’s hunger signals (or through other mechanisms). This includes certain blood pressure and diabetes medications.

How can I manage obesity as an older adult? 4 strategies

If you want to shed extra weight, try starting with simple lifestyle changes. The goal isn’t about achieving a “perfect” number on the scale. Rather, it’s about improving your general well-being and reducing your health risks.

Strategies to help you manage obesity:

1. Focus on nutrient-dense foods. Eat well-balanced meals rich in lean proteins, whole grains, fruits, and vegetables. Limit processed foods, sugary drinks, and unhealthy fats. Also, pay attention to calories. MyPlate Plan can help you learn what you should be eating each day based on your age, sex, height, weight, and activity level.
2. Keep moving. Exercise doesn’t have to be intense to be effective. Walking, swimming, and strength training can help you maintain lean muscle mass, improve your balance, and fire up your metabolism. Even chair exercises or gentle yoga can benefit your mobility and flexibility. Try to find an activity you enjoy and make it part of your everyday routine.
3. Prioritize your sleep. Good sleep supports our metabolism, hunger regulation, and overall health. Aim for seven to nine hours per night, and try to keep a consistent bedtime routine. Limit your pre-slumber screen time and avoid caffeinated beverages late in the day to enhance your sleep quality.
4. Keep your stress in check. As mentioned earlier, stress can lead to weight gain—and it can be harder to manage stress as we age. Getting plenty of sleep and practicing techniques like meditation and deep breathing can help you feel more in control. It’s also important to seek support from your friends, family, and community.

What if I can’t lose weight on my own?

For some people, lifestyle changes alone may not be enough. In that case, other obesity treatment options may be considered:

Nutrition counseling or medical nutrition therapy

While these two options have similarities, they’re not the same:

• With nutrition counseling, you work with a registered dietitian (RD) or registered dietician nutritionist (RDN). They help you understand how diet affects your health and how to make sensible changes you can maintain over the long term.
• Medical nutrition therapy (MNT) involves a more detailed, personalized nutrition plan crafted by a registered dietitian to help you manage and improve your health conditions (e.g., obesity, diabetes). It’s tailored to your goals, your cultural preferences, and the latest research.

Intensive behavioral therapy

During intensive behavioral therapy (IBT), you work with a trained therapist. They help you develop positive weight management behaviors—such as making better food choices, setting realistic goals, and creating an environment that discourages overeating.

Anti-obesity medications

Your provider may prescribe medication if you have obesity or other chronic health issues related to excess weight—or if you’ve tried but been unable to lose weight through other methods. According to AMA, a person taking anti-obesity medication (AOM) for a year can expect to lose 3% to 12% more than if they were doing only lifestyle changes.⁵

Anti-obesity medications work best when combined with healthy eating and exercise. There are a growing number of drugs approved by the Food and Drug Administration (FDA) for weight loss, such as:

• Semaglutide (Wegovy, Ozempic)
• Tirzepatide (Zepbound, Mounjaro)
• Liraglutide (Saxenda)
• Phentermine-topiramate (Qsymia)
• Naltrexone-bupropion (Contrave)

Currently, more than 100 new weight loss medications are in various stages of development and testing.

Bariatric surgery

Bariatric surgery (e.g., gastric bypass) may be an option if obesity poses dangerous risks to your health. This surgery works by changing the structure of the digestive tract, which in turn can help limit the amount of food you can comfortably eat. It can also lower the calories your body can absorb and regulate your hunger and appetite hormones.

Like with any surgery, it's important to weight the risks versus benefits.

Bring up your concerns with your health care provider

Obesity is a serious health condition—but it’s both preventable and treatable. Whether it’s by tweaking your diet, moving more, or taking medication (or all of the above), there are many ways you can take control.

“If you're concerned about your weight or its impact on your health, don’t be shy about starting the conversation with your doctor,” recommends Gretchen Dueñas-Tanbonliong, Associate Director of Health and Wellness at NCOA. “And if they aren’t taking your concerns seriously, find a provider who does. You deserve compassionate, high-quality obesity care that respects your unique health needs.”

Sources

1. Centers for Disease Control and Prevention. Obesity and Severe Obesity Prevalence in Adults: United States, August 2021–August 2023. September 2024. Found on the internet at https://www.cdc.gov/nchs/products/databriefs/db508.htm

2. Alexis M. McKee, et. al. Obesity in the Elderly. Endotext. Updated September 19, 2021. Found on the internet at https://www.ncbi.nlm.nih.gov/books/NBK532533/

3. Silvia G. R. Neri, et. al. Does Obesity Increase the Risk and Severity of Falls in People Aged 60 Years and Older? A Systematic Review and Meta-analysis of Observational Studies. The Journals of Gerontology: Series A. April 17, 2020.

4. Centers For Disease Control and Prevention. FastStats: Sleep in Adults. May 15, 2024. Found on the internet at https://www.cdc.gov/sleep/data-research/facts-stats/adults-sleep-facts-and-stats.html

5. American Medical Association. Questions patients may have about weight-loss drugs. July 17, 2023. Found on the internet at https://www.ama-assn.org/delivering-care/public-health/questions-patients-may-have-about-weight-loss-drugs#