Weight loss after 65 is more nuanced than simply looking at a number on the scale or a standard BMI chart.
In Episode 23 of The Geriatric Dietitian Podcast, I’m wrapping up our five-part series on BMI in older adults by answering an important question: What if an older adult actually wants or needs to lose weight?
There are many reasons someone may want to lose weight. Some older adults may have spent decades focused on their weight or clothing size, while others may have been told to lose weight for a medical reason, such as before a procedure.
The answer isn’t simply to tell older adults they should never lose weight. Instead, we need to look at the bigger picture.
BMI and Weight Loss After 65
Standard adult BMI categories classify a BMI of 25 to 29.9 as overweight and a BMI of 30 or higher as obese.
But as we’ve discussed throughout this series on the podcast, BMI needs to be interpreted differently in older adults.
Research in adults over age 65 has found that the BMI range associated with the lowest mortality risk is higher than the standard “normal” adult BMI range.
That means an older adult should not automatically pursue weight loss simply because a standard BMI calculator categorizes them as overweight.
BMI is only one number. It does not tell us how well someone is eating, how active they are, how much muscle they have, how strong they are, or whether they are able to function independently.
Consider Weight Stability
Another important consideration is someone’s usual body weight. Has their weight been fairly stable over time? Are they strong? Are they eating well? Are they maintaining muscle? Are they functionally independent?
Weight changes can give us important information about an older adult’s health.
Research discussed earlier in this series found that older adults who lost weight, including muscle or fat, had higher mortality than those whose weight and body composition remained stable.
And when someone loses weight, they aren’t necessarily losing only body fat. They may also lose muscle.
Protect Muscle During Weight Loss
If there is one message I want you to remember from this episode, it is this:
Preserve muscle.
Older adults are already at risk for age-related muscle loss, or sarcopenia. Muscle supports strength, mobility, the ability to complete everyday tasks, and independence. If an older adult chooses to pursue intentional weight loss, protecting muscle should be a major priority.
Two important pieces of this are:
- Adequate protein
- Resistance exercise
Resistance exercise may include strength training, lifting weights, resistance bands, or other exercises that work the muscles.
Protein intake also matters. Research suggests that distributing protein throughout the day may be associated with greater muscle mass in older adults. Instead of getting most protein at dinner, think about including good sources of protein at breakfast, lunch, dinner, and snacks when appropriate.
The goal isn’t simply to lose weight. The goal is to maintain as much muscle as possible while weight loss occurs.
Look at the Whole Person
Before pursuing weight loss after 65, there are many questions worth considering.
What does the person usually weigh? Why do they want to lose weight? Is there a medical reason? What is their current nutrition status? Do they already have signs of muscle loss or malnutrition? Are they frail? Are they maintaining their strength and function? Are they getting enough protein?
These questions tell us much more than simply saying someone has a BMI above 25 and therefore needs to lose weight.
It is also possible for someone living in a larger body to be malnourished or have sarcopenic obesity, meaning they have a larger body size but relatively low muscle mass.
This is why overall health, nutrition, strength, function, and quality of life need to remain part of the conversation.
What to Consider Before Losing Weight After 65
If you are an older adult thinking about losing weight, or you are helping an older adult who wants to lose weight, here are the main ideas from this episode:
- Learn about BMI in older adults before assuming standard adult BMI categories should determine your weight goal.
- Consider usual body weight and weight stability.
- Look beyond the scale at muscle, strength, nutrition, function, and overall health.
- If intentional weight loss is appropriate, prioritize preserving lean body mass with adequate protein and resistance exercise.
- When possible, work with a geriatric dietitian who can help you look at your individual situation.
Ultimately, the goal isn’t to create the smallest possible version of someone.
We want older adults who are strong, nourished, functioning, and able to maintain their independence for as long as possible.
Preserve muscle, prioritize good nutrition, work with your healthcare team, and focus on the bigger picture rather than only the number on the scale.
The BMI in Older Adults Series
This episode wraps up our five-part series on BMI and weight in older adults:
Episode 19: Understanding BMI in Older Adults
Episode 20: Optimal BMI for Older Adults: What the Research Shows
Episode 21: Sarcopenia in Older Adults: Why Muscle Matters More Than Weight
Episode 22: Unintentional Weight Loss in Older Adults: When to Be Concerned
Episode 23: Wanting to Lose Weight After 65? What to Consider
Learn More
Get my FREE Healthy Aging Nutrition Resource:
https://thegeriatricdietitian.myflodesk.com/
This content is for educational purposes and is not individualized medical or nutrition advice. Talk with your healthcare team before making major changes to your diet, exercise routine, or weight.