Obesity Threatens to Tarnish the "Golden Years"

By Hugh C. McBride

Dr. Mike Magee isn't a mathematician, but when he looks at the health outlook of people in the United States, he sees an equation as simple as it is stark: Aging + Obesity = Serious Consequences.

In an article on the "Health Politics" online news and information service that he founded, Magee describes the confluence of aging and obesity as "two intersecting and compounding megatrends" that threaten the health of millions of adults. And he isn't alone in his concerns about America's aging population.

A GLOBAL EPIDEMIC

Magee and many others have focused their attention on the United States, but the negative effects of overweight are being felt around the world. According to the World Health Organization, obesity is officially a global epidemic with more than one billion adults classified as overweight, and 300 million also meeting the Body Mass Index threshold for obesity.

As these individuals transition into what some hope will be their "golden years," they are discovering that many of the physical and emotional challenges of aging are exacerbated by their excess weight.

A REDUCED QUALITY OF LIFE

Life expectancy in the United States has been on an upswing for more than a century. For example, a newborn in 1900 was likely to live 47 years, while a child born a century later would live past age 75. But as overweight and obesity rates continue to rise, health care professionals are seeing a related decrease in the quality of life of many older Americans.

"The combined effects of aging and the obesity epidemic results in bigger body size and less lean mass among the elderly," wrote Jingzhong Ding, M.D., Ph.D., lead author of a study on aging and weight that was conducted by Wake Forest University School of Medicine. "This may lead to disability and other illnesses in the elderly and could be dramatic in the coming years."

As humans age, declining metabolism, decreasing muscle mass, and a more sedentary lifestyle are three factors that contribute to weight gain. And though these issues challenge almost all who reach "a certain age," they are magnified in individuals who entered adulthood with a history of overweight or obesity.

Obesity increases one's likelihood of developing a number of medical conditions, including hypertension, Type-2 diabetes and coronary artery disease. According to the Obesity in America website, obese individuals account for more than 60 percent of hypertension cases and 80 percent of all incidences of Type-2 diabetes.

Individuals who bring these and other health issues with them into middle age and old age put a greater strain on their bodies, and may find themselves more likely to have difficulty completing core functions such as standing, walking, shopping, attending events like movies, or participating in social gatherings. (According to an analysis performed by Georgetown University's Center on an Aging Society in the 2000 Health and Retirement Study, obese individuals age 51 and older reported greater difficulty performing all of these tasks than did non-obese adults in the same age range.)

A study by the University of South Florida's School of Aging Studies supports these findings. "Active life expectancy is ... significantly shorter for the elderly obese and disabled life expectancy significantly longer," researcher Sandra Reynolds said in a USF press release announcing the study's publication in The Gerontologist journal. "Having difficulty with [activities of daily life] ... can make the excess years of disability difficult for individuals, their families and society," Reynolds noted.

Weight-related issues also impact productivity, with The Center on an Aging Society reporting that only 55 percent of obese adults age 51 and above are still working, compared to 59 percent of their non-obese counterparts.

THE EMOTIONAL IMPACT

In addition to the physical risks associated with aging while overweight, individuals at the high end of the BMI scale also deal with emotional scars. For example, the Center on an Aging Society's report revealed that obese adults age 51 and older reported significantly higher depression-related emotions (sadness, hopelessness, worthlessness) that did non-obese members of the same age group.

Though studies suggest that between two and four percent of the general population may be suffering from clinical depression at any one time, researchers have found depression rates among elderly individuals - particularly those in nursing homes or other assisted-living facilities - as high as 15 to 25 percent. Because depression has also been linked to physical ailments such as heart problems, aging individuals who are also overweight may find themselves at even greater risk of developing debilitating medical conditions.

A GROWING DILEMMA

A University of Cincinnati analysis that was published in the November 2004 issue of the Journal of the American Geriatrics Society predicts that the number of obese adults over the age of 60 will increase by 43 percent over the current decade - rising from 14.6 million in 2000 to 20.9 million by 2010.

"This 43 percent increase in obese adults over 60 is significantly higher than the estimated population increase - approximately 23 percent - for that age group between 2000 and 2010," noted Dr. David Arterburn who led the UC analysis team.

An additional problem facing all aging individuals is that the system designed to meet their health care needs is in danger of being overwhelmed. In a study that was released on April 14, 2008, the U.S. National Academy of Science calls for an "immediate and dramatic" increase in the number of medical professionals who specialize in geriatric care.

"We're going to need more and better [health care for the elderly]," David Reuben, a researcher with the University of California at Los Angeles who helped prepare the study, told Bloomberg News. "We also need better training of existing health professionals and direct caregivers."

CHANGING THE EQUATION

Most research seems to support Dr. Magee's prediction that aging while obese will result in serious consequences - but the good news for overweight adults is that they can alter the outcome by changing the equation. Growing older is inevitable, but individuals can increase their odds of aging in a healthy manner by getting their weight under control.

Even small improvements can have dramatic results. According to a study published in the Annals of Internal Medicine, losing even five to 10 pounds can significantly lower one's blood pressure. And the American Association of Retired People reports that individuals with Type-2 diabetes had lowered blood sugar - and needed less medicine to control their sugar levels - after they lost weight.

Though the risks of aging while overweight are well-documented, so, too, is the path to better health and an improved quality of life. Thousands of once-overweight adults have made the necessary lifestyle changes that are allowing them to age in a healthier manner - and thousands more are on the way to weight control.

As the AARP advises on its Healthwise website, "Anything you can do today that was healthier than yesterday is a step in the right direction."

Sources

• AARP Healthwise - http://www.healthwise.net
• "Combined effects of aging and obesity" (News-Medical Net) - http://www.news-medical.net/?id=21758
• Health Politics with Dr. Mike Magee - http://www.healthpolitics.org
• HealthyPlace Depression Community - http://www.healthyplace.com/communities/depression/elderly.asp
• Obesity Among Older Americans (Georgetown University Center on an Aging Society) - http://hpi.georgetown.edu/agingsociety/pdfs/obesity2.pdf
• "Obesity more likely to cause disability" (University of South Florida) - http://usfnews.usf.edu/page.cfm?link=article&aid=1005
• "Study Predicts Shortage in Geriatric Health Care" (Bloomberg News, April 15, 2008) - http://www.ohio.com/news/top_stories/17717919.html