Helping Patients with Obesity Age Healthier and Happier

As our patients transition into the new year, they may evaluate their health goals and set lofty nutrition and exercise targets. While New Year’s resolutions don’t always have the best track record for ongoing success, we can take advantage of the opportunity to educate our patients about long-term health habits that lead to happier and longer lives.

To enjoy a high-quality life with as much independence as possible, healthy aging requires maintaining strength, mobility, and cognitive function. It also involves minimizing chronic pain and disability and reducing the risk of diseases, such as obesity, type 2 diabetes, and cardiovascular disease (CVD).

Given that more than one-third of older adults already live with obesity and that obesity is a primary risk factor for both diabetes and CVD, it’s critical to guide our older patients on how to mitigate this key risk factor as they age. Obesity is a chronic yet treatable disease, and because older adults with obesity face an increased risk of micro-nutritional deficiencies, it’s important to discuss diet and nutrition when planning long-term treatment.

Make Nutrition Personal

There is no one-size-fits-all approach to nutrition, which is why it is important to work closely with older patients to design a personalized diet. Changes in body composition (eg, loss of muscle mass, increased body fat, decreased bone density), are a natural part of aging; but obesity and metabolic disease in older adults can have a significant impact on morbidity, mortality, and quality of life. Weight loss can promote several improvements to physical function—a key indicator of healthy aging.

Our understanding of weight management has evolved beyond the old “eat less and move more” advice. We now know that physical activity promotes healthy aging outcomes, including positive changes in body composition, strength and balance, and improved insulin sensitivity.

When it comes to nutrition, today’s most popular diet plans have many similarities, such as an avoidance of processed foods; an emphasis on consuming fresh vegetables, nuts and other minimally processed foods; and promotion of healthy fats and proteins.

Healthy Aging Diets

• The Mediterranean Diet: This diet became prominent in the 1960s when it was discovered that coronary disease caused fewer deaths in countries,such as Italy and Greece where the dietary pattern was endemic. The Mediterranean diet plan includes daily consumption of vegetables, fruits, whole grains, and healthy fats; weekly intake of poultry, fish, beans, and eggs; moderate portions of dairy products; and limited intake of red meat. Medical benefits include improved lipid and lipoprotein profiles, improved insulin sensitivity, lower blood pressure, and reduced inflammation. Adhering to the diet is associated with a 50% lower mortality rate among individuals aged 70 to 90 years old, suggesting the eating plan might also benefit older adults with obesity.
• The Plant-Based Diet: Vegetarian and vegan styles of eating that emphasize whole, minimally processed foods and avoid animal products can, like the Mediterranean plan of eating, also support positive cardiovascular outcomes. Plant-based food plans are associated with reduced blood lipid concentrations and a lower risk of CVD, which can make them a good choice for older patients with obesity who are concerned about maintaining nutritional status. However, it is important that these patients also consume sufficient high-quality protein to maintain muscle mass, and supplement vitamins and minerals that may be deficient in a plant-based diet, such as vitamin B complex, calcium, vitamin D, and iron.
• The Keto Diet: A well-formulated ketogenic diet plan is low-carb, high-fat, and includes moderate proteins. It emphasizes whole foods, such as non-starchy vegetables, low-sugar fruits, healthy fats, and proteins or vegan sources (eg, tofu). The diet’s appetite suppressing effect makes it effective for promoting weight loss and it can also improve blood glucose control, lower triglyceride levels, and reduce blood pressure, making it a good option for older patients with metabolic disease.

We play an important role in helping patients manage obesity and achieve healthy outcomes as they age and working to advance our knowledge of obesity medicine is essential to that role. The Obesity Medicine Association (OMA) offers a spectrum of educational tools and resources to support that education. Designed for all health care providers who treat patients with obesity, the Fundamentals of Obesity Treatment Virtual Course provides introductory education about the evidence-based approaches for evaluating, diagnosing and treating obesity in a clinical setting.

To become an OMA member, visit https://obesitymedicine.org/join.

Karli Burridge is an internationally recognized, award winning leader in obesity management. She is a physician assistant and Fellow of the Obesity Medicine Association and holds the Certificate of Advanced Education in Obesity Management. She is the President of PAs in Obesity Medicine and serves on the Board of Trustees for the Illinois Obesity Society.

Karli is the owner of Gaining Health, which she developed to provide resources and tools for providers who want to incorporate obesity management into their medical practice. She is also a clinical provider for Enara Health, a telemedicine-based obesity medical weight management organization.