Promotingoptimal in health for older people with obesity
Thereis an increasing prevalence of obesity epidemic among older adult inthe world that requires utmost attention. Obesity is one of theperpetuating factors of mortality, besides heart disease, diabetes,and cancer. According to “National Health and Nutrition ExaminationSurvey (NHANES),” the pervasiveness of obesity among people aged 65and above is more than a third of the entire population segment.Obesity is an independent risk factor for various diseases such ascardiovascular, heart failure, diabetes, and hypertension, amongothers. The rise in obesity incidences has a paramount impact on thegeneral life expectancy. There is evidence from research studies thatincreasing obesity cases in the might lead to reduced life expectancyin the future. The paper aims at constructing appropriate optimalmedical program for elderly people with obesity.
Keywords:obesity, “Body Mass Index” (BMI), geriatric obesity, “TotalEnergy Expenditure” (TEE).
Promotingoptimal in health for older people with obesity
Obesityis a disease that is characterized by unhealthy excessive body fatsthat heighten the risk comorbidities and premature mortality.Nevertheless, the medical concern for obesity presents healthprofessionals with multiple challenges as it is hard to find andaccurate measure of body fats[ CITATION Ama14 l 1033 ].The process demands the use of enhanced technology that is rare tofind in the typical medical setup. As a result, the most common andwidely accepted technique has been tocalculate, “the BMI as body weight, in terms of kilograms, dividedby the individual height, in terms of meters[ CITATION Sta16 l 1033 ].”
Theprimary cause of obesity among older adults is the disparity betweenenergy intake and consumption. According to most research studies,energy consumption among older people is less likely to change. Onthe other hand, the expenditure of energy is more likely to decline,resulting in gradual body fat buildup. Therefore, it is evident thatincreased fat mass among geriatric people is attributable to higherenergy intake levels, a drop in energy consumption, or both[ CITATION Sta16 l 1033 ].Moreover, physical activities reduce with advancing age thusreducing all the principal elements of Total Energy Expenditure (TEE)such as the thermic food effect, resting metabolic rate, and physicalactivities which constitute 70%, 10%, and 20% of the total TEE, respectively[ CITATION Sta16 l 1033 ].The decline of these components directly affects the total energyexpenditure hence contribute to increased body fats.
Onthe other hand, hormonal change and imbalance that occurs withadvancing age accelerate the buildup of fat. Aging is associated withthe decline in growth hormones, reduced serum testosterone, and lowreceptiveness to thyroid hormone thus increasing fat mass.
Adverseeffects of obesity
Obesityis directly related to the increased death rates. However, absolutemortality risk linked to higher body mass index escalates with age,until the optimal age of 75 years after which the association isweakened[ CITATION Fel13 l 1033 ].Therefore, “thereis a linear relationship between body mass index and mortality rateup to the age of 75 years[ CITATION Sta16 l 1033 ].”
Obesityis attributable to myriad serious medical difficulties that lead toweakened quality of life, substantial morbidity, and early death. Onthe contrary, most research studies investigating obesity-relatedproblems have been performed with the middle-aged group[ CITATION Sta16 l 1033 ].The pervasiveness of medical complications related to obesity, suchas diabetes, osteoarthritis, hypertension, and cardiovasculardiseases increases with advancing age.
Researchstudies have attributed elements of metabolic syndromes such as highblood pressure, excess abdominal fats, and dyslipidemia among otherwith advancing age. The information and data collected showed anincreasing prevalence of metabolic syndrome with age.
Otheradverse medical conditions associated with obesity include cancer,arthritis, pulmonary abnormalities, cataracts, urinary incontinence,and reduced physical functionalities.
Beneficialeffects of obesity
Obesityhas been related to “higher bone mineral density (BMD) and a lowosteoporosis and hip fracture among older adults[ CITATION Fel13 l 1033 ].”“The body fat mass and the fat-free mass have a direct correlationwith the bone mineral density[ CITATION Fel13 l 1033 ].”The fat mass and bone mineral relationship manifests higher in womencompared to men[ CITATION Ama14 l 1033 ].Moreover, high values of BMI among the elderly are connected with aslower bone loss rate brought by a deficiency in estrogen.
Obeseand overweight people, in the society, often face social consequencessuch as prejudice, negative attitude, and stigma. Stigma anddiscrimination typically refer to the negative attitudes thatsignificantly the social interactions. A potential stigma could be inthe form of verbal, physical or other hurdles due to weight. Inextreme cases, stigma could result in overt forms of bigotry such asemployment discrimination, despite these people being qualified andskilled. Doctors have identified stigma as one of the key inhibitorsof effective obesity intervention practices[ CITATION Fel13 l 1033 ].
Accordingto research studies, weight stigmatization triggers psychologicalstress and results into poor physical health[ CITATION Ama14 l 1033 ].These forms of social discrimination may affect obese people throughchronic anxiety, depression, and social isolation. Usually, stigmahas adverse eating behaviors as people tend to eat more to encounterthe stigma. Finally, obese individuals fear seeking medical adviceand treatment due to the discrimination healthcare settings. Stigma and prejudice toward obese people have becomepervasive and result in physical and psychological health problems,rather than solving the condition.
Adaptationsto lessen the condition
Thereare various strategies that health professionals, researchers, andclinicians could adopt to reduce the magnitude of stigma toward obeseolder people. For instance, medical professionals could make adifference by understanding, and creating empathy in addressing theconcerns of obese adults. It is important to approach obese patientswith professionalism and respect to ensure they feel comfortableseeking medical care.
Weightloss in obese people helps improve and lessen obesity-related medicaldifficulties and enhance the quality of life. A combination ofvarious strategies such as behavior therapy, energy-deficit diet,physical exercise, goal-setting, social support, and self-monitoringhelp reduce health complications associated with obesity. Regularphysical exercise not only helps in accomplishing weight loss, but itis important for older people as it ameliorates frailty.
Additionally,older people could seek pharmacotherapy where the introduction ofmedication is required to limit the absorption of fat.Pharmacotherapy is common among the elderly, though an introductionof pharmacological agents could add more burdens as older people arealready under various medications[ CITATION Sta16 l 1033 ].As such, there is a high chance ofnon-adherence and errors in administering the drugs. Currently, theapproved long-term prescription drugs for obesity are sibutramine andorlistat[ CITATION Ama14 l 1033 ].
Theonly recommended and effective obesity surgical treatment is theBariatric operation. According to statistics, “the Roux-en-Ygastric bypass and the laparoscopic adjustable gastric band are thecommonly used procedures in the United States[ CITATION Fel13 l 1033 ].”The individuals are required to have undergone the appropriatenon-surgical measures for at least six months, in vain. However,surgical procedures among older people tend to have highperioperative difficulties and lower success rates.
Obesityhas become a common and a pervasive condition among the elderly.Geriatric obesity increases with increase in age, but its prevalenceweakens with extreme old age. The reduction in physical activitiesand energy expenditures with old age results in the accumulation offat. Due to the various medical complications associated withgeriatric obesity, intervention measures are necessary. The majorfocus in treating geriatric obesity should be on the lessening ofintra-abdominal fat, conventional dietary restraint, preservation ofstrength through regular exercises. Finally, more research studiesare required to evaluate the efficiency of the intervention measuresmentioned above, and also to come up with other obesity treatmentprocedures.
Amarya, S., Singh, K., & Sabharwal, M. (2014). Health consequences of obesity in the elderly. Journal of Clinical Gerontology and Geriatrics, 5 (3), 63-67.
Felix, H. C., & West, D. S. (2013). Effectiveness of Weight Loss Interventions for Obese Older Adults. American Journal of Health Promotion, 191-199.
Starr et al, K. P. (2016). Challenges in the Management of Geriatric Obesity in High Risk Populations. Nutrients, 1-16.