Approach to obesity in the elderly population: a consensus report from the Diabetes, Obesity and Nutrition Working Group of SEMI (Spanish Society of Internal Medicine)

Abstract

Obesity in the elderly not only impacts morbidity and mortality but their quality of life. This phenomenon has sparked extensive research and debate regarding treatment recommendations, primarly due to the lack evidence in this specific population. When addressing possible treatment recommendations for older adults with obesity, it is crucial to assess certain essential aspects such as functional status, sarcopenia, cognitive status, and others. Intentional weight loss in this population can be both effective and safe. The best weight loss plan for the elderly revolves around adopting a healthy lifestyle, which includes following a Mediterranean diet pattern and engaging in physical exercise, particularly strength training. Additionally, the use of weight loss medications, particularly glucagon-like peptide-1 receptor agonists (GLP-1 RA) and novel glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 receptor agonists, can provide an additional stage of treatment. In selective candidates, bariatric surgery may also be considered. The objective of this document is to propose a comprehensive algorithm of recommendations for the management of obesity in the elderly (above the age of 65), based on scientific evidence and the expertise of members from the Diabetes, Obesity, and Nutrition Workgroup of the Spanish Society of Internal Medicine.