Do I Need to Lose Weight? 

Why Weight Charts Can Be Misleading for Seniors

If you’re a senior carrying extra pounds, you might assume that the best thing for your health is losing that excess weight. After all, being overweight or obese can increase your risk for many health problems, including:

• Type 2 diabetes
• Cardiovascular disease
• Some kinds of cancer
• Hypertension
• Osteoarthritis

However, determining the ideal body weight for elderly people is more complicated than merely consulting weight charts. So if you’re wondering what you should weigh, your first step should be an open conversation with your doctor. That’s because, for a senior, weight-loss goals must take several important factors into account, including overall health.

Some of the standard methods for determining an ideal weight change as we age. You may already be familiar with the concept of body mass index or BMI. (You can determine your BMI with an online calculator.) Your BMI reflects your weight-to-height ratio.

The standard ranges for BMI are:

• Underweight: BMI that is less than 18.5
• Normal weight: BMI between 18.5 and 24.9
• Overweight: BMI between 25 and 29.9
• Obese: BMI over 30

However, many people feel that BMI oversimplifies weight issues. One reason is that BMI doesn’t account for the fact that muscle is denser than fat. A person who has a lot of muscle could have a much higher BMI than someone who wears the same size of clothing but has less muscle. (In fact, many professional athletes fall into the “obese” category on the BMI chart simply because they have so much muscle mass.)

But what does this mean for seniors? Here’s a key fact: Our body composition often changes with age. (Body composition is the amount of muscle and fat on your frame.) An article from Tufts University notes that many seniors experience sarcopenia, or muscle loss, as they grow older. And losing muscle may have a more significant impact on health than carrying extra weight. So lower weight isn’t necessarily a good thing if it’s the result of muscle loss.

The Tufts University article cites studies that have found that being underweight as a senior carries more risk than being overweight. That might seem counterintuitive, but overweight people who are older than 65 have lower mortality rates than people who are underweight or within the normal-weight range. (Some doctors call this the “obesity paradox.”)

That means our ideal BMI often shifts upward with age. As a result, some medical experts have suggested that there should be a separate “BMI for older adults” chart that contains slightly higher numbers. This kind of weight chart for seniors would use a range of 25 to 27 as a “normal” BMI.

Your weight-loss goals will also depend on your individual health issues. For example, the ideal weight for men over 60 with diabetes may be lower than for other men in that age group. And a weight chart for females over 50 who have not gone through menopause might be different from a weight chart for women over 60 because the hormonal shifts of menopause can trigger body composition changes.

Instead of just striving for a lower weight, it may be healthier to focus on your body composition (i.e., your muscle-to-fat ratio), and where fat is stored on your body.

Why is the location of excess fat important? People tend to store fat either above their hips (mostly in their bellies) or below their hips. Fat that is stored above the hips presents a greater risk for:

• Heart disease
• Stroke
• Diabetes
• Insulin resistance
• Alzheimer’s disease

Because of the increased health risks carried by belly fat, waist circumference is often an important indicator of overall health. So, instead of looking at a weight chart for seniors to determine whether you need to lose weight, you could measure your waist-to-hip ratio and discuss the results with your doctor.

Essentially, if you’re focused on reaching an “ideal” weight, you may be focused on the wrong goal. Research suggests that instead of trying to lower your BMI, your focus should be on eating for your personal health and maintaining muscle tone and bone strength. That’s why it’s important to work with your healthcare provider to create personalized goals and plans that work for you.

Why Is Losing Weight Over 60 More Difficult? How Your Body Changes With Age

You may also have to revise your ideas about dieting if you and your healthcare provider determine that losing weight will help your overall health. That’s because many seniors find that weight loss gets more challenging as they get older. While slower weight loss can be frustrating, it’s also a natural part of the aging process. So, don’t blame yourself if you struggle to drop extra pounds. If a 60-year-old woman can’t lose weight, she might blame herself for not being disciplined enough. However, her body might just be responding in a way that’s appropriate for her age.

But that doesn’t mean that losing weight over 60 is impossible. Many people successfully lose weight at any age. You can lose weight as you get older by adapting your weight-loss strategies to your changing body.

The first step in understanding why weight loss rules can be different for seniors is to consider your basal metabolic rate. That’s the number of calories you burn just staying alive (i.e., the energy you expend breathing and digesting food). This rate is different than the calories you burn through exercise or everyday activities.

Your body composition impacts your basal metabolic rate. That’s because, in addition to its heavier weight, muscle burns more calories than fat. So a person who has a lot of muscle mass should have a higher basal metabolic rate than someone who doesn’t.

However, starting in our 30s, we lose muscle mass unless we work to maintain it. Although we may not even notice this process when it starts, it has a large impact over time. One study published in Clinical Interventions in Aging found that, on average, we lose about 30 percent of muscle strength between age 50 and 70. And the rate of muscle loss is even faster after 70. Consequently, losing weight after 70 will be that much harder than it is for someone who is 30.

If you continue to eat the same number of calories and do the same amount of activity as you did in your younger days, you could be at risk of gaining weight because your basal metabolic rate is slowing down.

As a result, the number of calories you should eat in a day is about 100 calories lower with every decade you age. That’s not a huge amount (about the equivalent of one apple). But it does add up. So, for example, all other factors being equal, a 60-year-old woman should eat fewer calories in a day than a 40-year-old woman to lose weight.

Although it might seem unfair in today’s more sedentary world, this process makes sense from an evolutionary standpoint. Long ago, as we grew older and our hunting and gathering abilities slowed down, our bodies had to learn how to survive on less food. The result? Aging bodies want to hang onto any extra body weight (even if we no longer need – or want – them to).

As well, for many seniors, weight loss slows down because of additional factors that affect their metabolisms, including:

• Medications: Seniors are more likely to be taking medications that can contribute to weight gain and make it harder to lose weight. But the effects are often hard to predict. For example, some people find that the antidepressant Wellbutrin can help with weight loss, but others find that they gain weight while taking it. If you’re concerned about a medication’s impact on your weight, be sure to talk to your doctor.
• Gastrointestinal changes: Some seniors avoid fresh fruits and vegetables because they don’t want to upset their stomachs. If you’re experiencing digestive issues that interfere with a healthy diet, your doctor can help.
• Certain medical conditions: Some health issues that are common in seniors can slow weight loss. For example, when your thyroid doesn’t produce enough thyroid hormone, your metabolism can slow down. You can lose weight with an underactive thyroid by working with your doctor to restore your thyroid hormone levels.