This paper examines obesity among older adults as a growing public health concern, projected to affect a significantly larger share of the population by 2030. It identifies the biological, genetic, environmental, and sociological causes of obesity in aging individuals, and discusses the social stigma that compounds the condition's psychological and economic burden. The paper outlines evidence-based weight-loss strategies—including caloric reduction, physical activity, and behavioral therapy—and proposes a structured health promotion program with individual- and community-level interventions. Three program goals targeting awareness, healthcare provider engagement, and reduction of obesity disparities are presented alongside recommendations for policy and clinical practice.
At present, 7% of the global population is aged over 65 years. This percentage is expected to increase to 12% by 2030. In America, the figure is likely to rise from 35 million (12%) to 71 million (20%) by the year 2030 (Newman, 2009). This considerable rise in the older adult population indicates that a significant public health issue in the near future will be obesity in older citizens. In the last three decades, the number of obese older individuals has increased twofold (Newman, 2009). This increase reflects both a rise in the total number of older obese adults in the USA and a rise in the percentage of the obese population overall (Newman, 2009). Severe health complications and impairment in quality of life arise from obesity. Furthermore, in older adults, obesity can aggravate the physical function deterioration that comes with age, causing frailty. However, appropriate obesity treatment in older adults is debatable, owing to a decrease in corresponding health risks with increased body mass index (BMI), and concerns that weight loss could potentially have harmful impacts on older individuals (Villareal, Apovian, Kushner, & Klein, 2008).
Modern aging goals deal not just with lifespan extension, but also with experiencing healthier, independent years and reduced morbidity in old age. Though it is commonly believed that sickness increases in proportion to one's age, a more encouraging view holds that the older people get, the healthier they have been (Feeney, 2010). A marked increase in older obese persons is due to a rise in the total older population, as well as an increase in the percentage of the obese older population. Obesity has significant functional effects in older adults — it aggravates physical function deterioration that accompanies aging, causing infirmity known as sarcopenic obesity. It is therefore especially vital to consider therapies for weight loss and lifestyle changes toward nutritious food for improving obese older adults' physical function, as well as potentially improving or preventing medical complications linked to obesity (Villareal, Apovian, Kushner, & Klein, 2008).
A key determinant of fat mass in the body is the relationship between energy intake and expenditure. Obesity results from greater calorie consumption compared to calorie burning. Calories are required for sustaining life and staying active; however, maintaining a healthy weight requires balance between the quantity of energy ingested as food and energy expended (Newman, 2009). Decreased energy expenditure may likely lead to increased body fat with aging, especially in those aged 50–65 years. In individuals over 65 years of age, hormonal changes accompanying aging may result in fat accumulation. Aging is linked with decreased secretion of growth hormone, decreased thyroid hormone responsiveness, leptin resistance, and reduced serum testosterone (Newman, 2009).
Obesity runs in families, which may cause one to assume it relates to inherited genes; science also demonstrates an association between heredity and obesity (Newman, 2009). There appears to be an element of interaction between genotype and overfeeding with regard to body fat, suggesting that an individual's sensitivity to body fat changes after overfeeding depends on genotype. Researchers in a recent study employed structural equation modeling (SEM) to determine the specific relationship of genetic loci affecting adiposity with those affecting muscle growth (Newman, 2009). Such studies substantially contribute to understanding gene expression and its role in expanding knowledge on obesity. While nothing can be done about genetic inheritance, other factors contributing to an individual's obesity can be identified and addressed (Newman, 2009).
Environment also contributes to obesity. The environment represents the surrounding world and impacts access to nutritious food as well as safe places for walking. It influences food choices, physical activity levels, and lifestyle behaviors (Newman, 2009). The environment may, in numerous ways, prevent individuals from eating healthful foods and exercising adequately. Examples include today's trend of eating out rather than cooking at home, high-calorie and high-fat foods available in workplace vending machines, neighborhoods lacking pavements, and a dearth of easily accessible recreational areas. Lower education levels and poverty are also associated with obesity; one reason these are risk factors is that processed, high-calorie foods are cheaper and more quickly prepared than fresh vegetables and fruits (Newman, 2009).
Other illnesses and conditions linked with obesity and weight gain include depression, hypothyroidism, polycystic ovary syndrome, and Cushing's syndrome. Older obese adults are more prone, compared to non-obese individuals, to report depression symptoms such as feelings of hopelessness, sadness, and worthlessness. Inadequate sleep and particular drugs — such as steroids and certain antidepressants that stimulate appetite, cause water retention, or slow metabolism — may also lead to obesity (Newman, 2009). The complex link between lifestyle patterns and functional ability may further be a noteworthy contributor. Activity intolerance, joint pain, and decreased mobility may cause weight gain due to reduced activity. Older persons have a greater tendency than younger adults to experience functional limitations linked to chronic illnesses, setting off a cycle of stress, pain, and depression that can produce lifestyle patterns contributing to obesity (Newman, 2009).
Stigma represents a common issue affecting individuals with disabilities. Disabilities in the form of developmental conditions or chronic illnesses — such as chronic obstructive airway disease or obesity — cause mental and physical impairments, in addition to major economic disadvantages, including denial of opportunities and lowered self-esteem. These societal discriminations and burdens together exacerbate the psychological strain of stigma. Stigma linked with obesity proves to be a significant socioeconomic and psychological burden for affected individuals and families. It forms a major obstacle to patients' acceptance of obesity as a disease and to sustained, meaningful treatment. Because changes in society occur extremely slowly, those in the medical field must take prompt action and lead efforts to overcome the societal stigma linked to obesity and other chronic illnesses (Wimalawansa, 2014).
Historically, stigmata were used for keeping the public safe from diseases in eras when the cause of those diseases was unknown. With advances in medical knowledge, some stigmata disappeared; however, disabled or chronically ill individuals — including the obese — are still stigmatized. Obese individuals do not pose a risk to society, as obesity is not communicable; illogical and unwarranted statements to the contrary lie at the root of stigmatization of overweight and obese people (Wimalawansa, 2014).
In Brownell and Puhl's 2001 review, research providing evidence of weight-based discrimination and prejudice in employment contexts was summarized. At that time, developing evidence revealed that obese and overweight employees were stereotyped by their employers — their weight led to disadvantages in hiring, pay, job termination, and promotion. Since then, a surge in large population studies, experiments, and survey research focusing on weight-based employment discrimination has occurred (Puhl & Heuer, 2009).
"Diet, exercise, and behavioral therapy approaches"
"Individual and community program goals and interventions"
"Program results and clinical policy recommendations"
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