Abstract
Introduction. The traditional definitions of overweight and obesity are not age specific, even though the relationship of weight to mortality is different for older adults. Effects of adiposity on aspects of health beside mortality have not been well investigated. Methods. We calculated the number of years of healthy life (YHL) in the 10 years after baseline, for 5,747 older adults. YHL was defined in 16 different ways. We compared Normal and Overweight persons, classified either by body mass index (BMI) or by waist circumference (WC). Findings. YHL for Normal and Overweight persons differed significantly in 25% of the comparisons, of which half favored the Overweight. Measures of physical health favored Normal weight, while measures of mental health and quality of life favored Overweight. Overweight was less favorable when defined by WC than by BMI. Obese persons usually had worse outcomes. Discussion. Overweight older adults averaged as many years of life and years of healthy life as those of Normal weight. There may be no outcome based reason to distinguish Normal from Overweight for older adults. Conclusion. The “Overweight paradox” appears to hold for nonmortality outcomes. New adiposity standards are needed for older adults, possibly different by race and sex.
Highlights
The traditional definitions of overweight and obesity are not age specific, even though the relationship of weight to mortality is different for older adults
We calculated the number of years of healthy life (YHL) in the 10 years after baseline, for 5,747 older adults
Overweight older adults averaged as many years of life and years of healthy life as those of Normal weight
Summary
The traditional definitions of overweight and obesity are not age specific, even though the relationship of weight to mortality is different for older adults. There may be no outcome based reason to distinguish Normal from Overweight for older adults. Standard definitions of overweight and obesity, based on body mass index (BMI), do not differ by age [1]. Many studies of older adults have found a U-shaped relationship between BMI and mortality, with the lowest mortality in the group labeled as “overweight” (BMI from 25 to 29.9) [2] This surprising finding is often called the “Obesity Paradox.”. Even if Overweight older adults live as long as persons with Normal BMI, they may spend more of those years being sicker, more disabled, or with worse physical function. This paper will attempt to provide insight into both of those issues
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