Treatment of Obesity in the Elderly Patient
Obesity is a universal health complication that affects individuals of age ranging from childhood to elderly. According to the study report published by National Institutes of Health (NIH), half of the American populations are either overweight or obese. In the elderly section specifically it is estimated that over 37 per cent are overweight and 15 per cent are obese.
The secondary co-morbidities linked up with obesity in the elderly are heart disease, high blood pressure, high cholesterol, type II diabetes, stroke, liver and gallbladder disease, sleep apnea, osteoarthritis, and breast, prostate and colon cancer. These health concerns are considered as a profuse financial obligation for the United States.
Etiology
Aging draws a parallel to sarcopenia which is characterized by an age-related reduction in the muscle mass. In addition to this decline in the muscle mass, resting metabolic rate as well as level of physical activity also decrease. As a result, elderly individuals need fewer calories in order to maintain their body on a regular basis. Obesity in the elderly may occur when the aging adult becomes unsuccessful to reduce their calorie intake to correspond with their reduced caloric outflow.
Another scientific theory suggests that obesity in the elderly may also be resulted due to mutilation between the response mechanisms of leptin levels and appetite management. According to this theory, it is assumed that an increase in leptin level may eventually lead to the inhibition of appetite and heightened caloric outflow. Research suggests, elderly individuals typically have lower levels of leptin as compared to the young individuals.
Diet
While considering the treatment of obesity in the elderly patient, compliance to a healthy hypocaloric diet and behavioral alteration must come in the first line of weight management. Decreasing caloric intake by 500 calories per day will typically bring about a slow but steady weight loss, one to two pounds per week approximately. The elderly patients must restrict their fat intake per day to less than 30 per cent with no more than 10 per cent of saturated fat in total.
Exercise
Exercise plays an integral role in successful weight management program. For all physically active individuals, exercises should be a lifetime activity. Research shows there is a strong correlation between regular exercise and a decreased risk for cardiovascular complication. As suggested by different scientists and scholars, progression of sarcopenia is reduced if resistance exercise is practiced regularly.
During the management of obesity in the elderly, the patients are exposed to three essential goals during their exercise practice session. These goals are - increased flexibility, increased strength and increased cardiovascular endurance. The primary exercises are stretching practice, targeted heart rate practice, walking, cycling, and low-impact aerobics. However, it is highly discouraged to start any sort of exercise programs prior taking consent from physician.
Pharmacologic Therapy
As specified in the clinical guidelines of obesity, obese patients must try to lose 10 per cent of total body weight within a six month period with the help of behavioral modification, diet, and exercise. If this can not be attained, then pharmacological agent can be introduced, particularly for those individuals suffering from high blood pressure, diabetes and dyslipidemia. Although the advantages of pharmacological therapy have been proven beneficial for young and middle-aged people, the pharmacological research on obese elderly is not abundant.
