Working with a doctor or nutritionist, older adults can develop a plan for weight management that addresses their individual needs.

Weight management can be a complex process for people ages 65 years and older. Medical conditions, mobility issues, and certain social factors can contribute to changes in weight.

Whether your weight is above or below your optimal range, weight management strategies will likely involve addressing habits related to nutrition and physical activity.

In this article, we discuss weight loss and weight gain as they relate to health in older adults.

Research suggests that overweight and obesity are becoming more prevalent in older adult populations. Of particular concern, according to the authors of a 2024 review, is the growing prevalence of sarcopenic obesity.

Sarcopenic obesity is the cooccurrence of obesity and sarcopenia (age-related muscle loss). This condition is linked with faster functional decline and the risk of chronic disease, disability, and death.

If you have overweight or have obesity and are over the age of 65 years, it’s important to speak with your doctor before taking any steps to lose weight. This is because your current body weight may be appropriate for your age, gender, and current health conditions.

One reason for this is the obesity paradox. This is a finding that older adults with overweight and a specific disease have better health outcomes than people with moderate or underweight with the same diagnosis.

In fact, some research has found that weight loss among those with a higher BMI at an older age may contribute to unintended negative side effects, such as:

However, the obesity paradox is a complex concept that’s difficult to prove, and depends on a range of personal health factors. The best course of action is to speak with a doctor about your specific situation.

Research supports the use of physical activity, diet, and bariatric surgery for managing overweight, obesity, and sarcopenic obesity in older adults.

The specifics of physical activity and dietary changes will vary widely based on the individual, their health status, age, and mobility.

While the Centers for Disease Control and Prevention (CDC) and the U.S. Department of Agriculture (USDA) offer guidelines for exercise and nutrition for older adults, they will likely need a customized weight loss plan developed by a doctor, dietitian, or other healthcare professional.

Despite this, you can take certain steps to lose weight past the age of 65 years. These include:

  • picking more nutritious versions of foods you commonly eat
  • limiting or avoiding beverages with added sugar
  • eating smaller portions
  • maintaining a diary of all the foods you eat
  • finding physical activities you enjoy and doing them on a routine basis
  • including strength and balance training in your exercise regimen

It’s also possible to lose weight without trying. If you or a loved one loses weight without a clear cause, it’s important to consult a medical professional for an assessment.

Older adults need to lose weight for various reasons. Medical, social, and environmental factors can play a role:

  • Loneliness and depression can affect appetite or cause a person to miss meals.
  • Mobility challenges can make it difficult to shop for food.
  • Age-related physical changes to muscle mass and bone density can lead to inactivity and weight loss.
  • Limited finances can also be an obstacle to proper nutrition.

    Unintentional weight loss is related to an increased risk of sickness and death. There are different potential medical causes, including:

    • Noncancerous diseases: These are the most common.
    • Cancer: This is responsible for as many as one-third of cases.
    • Medication: Taking medications can affect taste or cause nausea reducing the desire to eat.

    Experts estimate that between 6% and 28% of cases of unintentional weight loss have no identifiable cause.

    If you wish to gain weight, you can modify your diet and exercise habits. You may try to:

    • add protein to every meal
    • eat smaller meals more frequently during the day
    • snack on whole foods between meals
    • add high calorie foods such as nuts and cheese to snacks and meals
    • consume beverages high in calories, such as shakes, between meals
    • maintain a balanced diet
    • get regular exercise to promote appetite

    Older adults can face unique medical and environmental challenges. For some, the intersection of these challenges makes managing weight a complex task.

    Whether due to physical changes, health issues, medication, financial circumstances, or living conditions, older adults can find themselves needing to lose or gain weight to achieve the best health outcome.

    In either case, weight management often requires making changes to dietary and exercise habits. You should only make these changes in consultation with a healthcare professional and at their recommendation.