How to prevent and manage weight gain as we age

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As a doctor who treats an older population of Ohioans, I know that exercise is the most important part of aging well. 
 
It’s true for all generations, but exercise is especially beneficial for older adults. As we age, regular exercise will improve mobility and balance, support chronic disease management, and, of course, support healthy weight loss. 

Why some of us gain weight as we age

Some patients may experience weight gain with a change in work status such as retirement. Patients who stop smoking can have some weight gain, but the benefits of quitting tobacco far outweigh the risks of gaining a little extra weight. My main concern is to make sure there’s no underlying medical problem.

What doctors consider when it comes to weight

Baby boomers are unique in the way they view health care and self-care. Many of them wear individual health monitoring devices. I have patients who come with their own spreadsheets. I’m seeing an enormous variety in the health levels of patients around the age of 70, and they inspire me in many ways.
 
Most of my patients have long- and short-term goals that include living independently and enjoying their lives with travel and spending time with grandchildren. I try to help patients accomplish these goals through better self-care.
 
When my patients are concerned about their weight, we discuss several broad areas of health. Especially when I see a patient for the first time, I want to understand their health history. Has weight management been a lifelong issue? Or is this a new problem?
 
First, I look at their body mass index (BMI). This is one of the ways the healthcare profession classifies patients to help determine what constitutes a normal weight. If your BMI is greater than 30, we may need to consider a formal weight loss program, but we need to look at other factors as well. 
 
If you’re overweight when you’re younger, you tend to age with a heavier weight. But if the weight gain has been sudden or recent, we need to rule out two possible causes. First, what medications are you currently taking? They may have side effects such as weight gain. Next, patients may have cardiovascular or liver problems that cause weight gain, sometimes referred to as water weight. Those need to be ruled out right away, as they can be serious or even life-threatening.
 
I also watch out for patients who are in another group — those who are overweight but undernourished due to poor diet. And there’s an additional category that goes along with that — patients who had bariatric surgery and have re-gained the weight they lost immediately following the procedure. They may experience nutritional challenges such as difficulty with vitamin and mineral absorption. 
 
After we rule out medical issues, we can discuss weight control through diet and exercise.  

Tips for weight management and self-care in older adults:

1. Fitness programs

Our bodies are meant to be active. A fitness routine can lead to a dramatic transformation. 
 
I encourage participation in programs like Silver Sneakers, which provides seniors with a reduced membership rate for some local fitness centers, along with other incentives and support. Those facilities often offer programs around senior health and fitness. Tai chi is wonderful for balance, for example. 
 
It warms my heart to see fitness classes that are accessible for all levels of ability. A class instructor may demonstrate a high-impact version of a movement with an instructor who models lower-impact or chair-based options. Adults can join a class at whatever stage they’re in and benefit. These classes can challenge you and keep exercise fun. 

2. Maintaining and increasing social connections

Social interaction is also important. My mother loved to go to senior fitness classes. (There was even a potluck every month that she enjoyed.) I enjoy exercise classes myself. I see all levels of fitness and get to know people over years of regular attendance. Developing those connections can be affirming. 
 
For people who shy away from group classes, fitness training is available one-on-one. That accountability with a trainer can inspire you to stick with a fitness routine. 
 
Significant losses of spouses, friends and peer networks are common experiences with this age group. Loneliness can be a big issue, particularly for men, as many men have social connections only through their spouse. Widowhood in combination with retirement can complicate grief and increase depression — even raising suicide risk.
 
It’s never too late to start exercising, and it’s never too late to make new friends. 
 
Dr. Tanya Gure specializes in internal and geriatric medicine at The Ohio State University Wexner Medical Center