Most elderly people's obesity does not begin in old age but gradually develops after middle age. As age increases, the basal metabolic rate of the elderly declines, and coupled with reduced physical activity after retirement, if dietary habits are not adjusted, it is easy for energy intake to exceed expenditure, leading to weight gain. Additionally, sudden weight gain in some individuals after entering old age may also be related to medication use. For example, glucocorticoids, certain antipsychotics, and antidepressants can all have side effects that lead to weight gain.
Obesity is not just an appearance issue but also a catalyst for various chronic diseases. It significantly increases the risks of hypertension, diabetes, cardiovascular and cerebrovascular diseases, and joint burden. Clinically, some high-risk body types require vigilance.
01 Panting upon movement—Lower limb swelling type
Some elderly people with heavier lower limbs often experience symptoms of "shortness of breath upon exertion," such as panting after walking one or two hundred meters or climbing an overpass, which only subsides after a brief rest. This may not be solely due to obesity but could indicate underlying heart dysfunction. While these elderly individuals may appear to have "heavy" lower limbs, it could actually be edema caused by abnormalities in heart or kidney function.
A preliminary assessment for edema can be made through the "finger pressure test": press the skin on the front of the calf or the dorsum of the foot with a finger. If an indentation appears and recovers slowly, it may indicate possible fluid retention, and medical attention should be sought promptly to check the functions of systems such as the heart and kidneys.
02 Big Belly and Thin Limbs - Abdominal Obesity Type
The abdominal obesity body type characterized by a large belly and thin limbs is a body type that requires special attention among the elderly population. Specifically, it is defined as a waist circumference greater than or equal to 90 centimeters for men and greater than or equal to 85 centimeters for women.
This type of abdominal obesity is likely due to the accumulation of visceral fat. Visceral fat accumulation is characterized by an increased waist circumference and relatively thin limbs, which is a core feature of metabolic syndrome. Abdominal fat accumulation increases the risk of cardiovascular disease, diabetes, respiratory problems, and may also affect hormonal balance.
03 Fat but not strong - Malnutrition type
Sarcopenic obesity is very common among the elderly population. As age increases, the body's anabolic capacity for muscle declines, leading to natural muscle deterioration. Although some elderly individuals consume a significant amount of food, their intake is unbalanced, resulting in fat accumulation, obesity, and malnutrition. Prolonged sedentary behavior and lack of exercise also easily contribute to the occurrence of sarcopenia.
Elderly individuals should manage their weight gradually and progressively
The primary principle of weight management in old age is "investigate before intervening." Before developing a weight loss plan, a comprehensive internal medicine evaluation should be conducted to rule out potential conditions such as hypothyroidism, cardiac or renal insufficiency, and malnutrition, in order to avoid misjudgment. Provided that physical condition permits, the core of weight management lies in "reasonable diet, moderate exercise, and gradual progress."
In terms of diet, it is recommended to eat until you are "70% full" at each meal, reduce the intake of refined carbohydrates such as white rice and white steamed buns, and appropriately replace them with coarse grains like corn, sweet potatoes, and oats. This helps stabilize blood sugar and reduce fat accumulation. You can also adopt the Mediterranean diet pattern, which involves consuming more vegetables, fruits, whole grains, fish, and olive oil while limiting red meat and processed foods. This not only aids in fat loss but also helps prevent cardiovascular and cerebrovascular diseases and cognitive decline.
In terms of exercise, avoid high-intensity, high-load "sweat-inducing" workouts. It is recommended to take a slow walk half an hour after meals, lasting 30 to 60 minutes each time, which can help control weight and improve post-meal blood sugar levels. You can also practice traditional health-preserving exercises such as Tai Chi and Baduanjin appropriately, as their gentle pace helps enhance balance, cardiopulmonary function, and improve mental state.
In fact, middle-aged and elderly individuals have certain advantages in weight loss: stable life rhythms, fewer dietary temptations, relatively lower psychological stress, making it easier to adhere to healthy habits. For the elderly, weight loss does not need to pursue rapid results; weight loss is not the ultimate goal. The key lies in improving quality of life and establishing a healthy lifestyle, thereby reducing the occurrence of complications.
