Mar. 15 2016

Weighing the Risks: Rising Obesity Rates Among Older Adults

As the ranks of obese seniors grow, their health problems strain the system.

It’s no secret that obesity is on the rise. Public health has expended a huge amount of energy on interventions to help combat this epidemic—particularly for children and young adults. Researchers focus on the early years for good reason—that’s when it’s easiest to prevent obesity. Once someone becomes obese it’s very difficult to reverse it. But older adults, who have been living with the condition for decades are feeling the effects of obesity too, and their specific needs are posing new challenges for policymakers and health professionals alike.

Currently, 38 percent of Americans aged 60 and older are obese, while rates of extreme obesity—classified as grade two (BMI 35-40) and grade three (BMI equal to or greater than 40)—have increased rapidly. From 2003 to 2011, the rates of grade three obesity rose from 2.8 percent to 4.4 percent for men, and from 6.9 to 8.3 percent for women.

“This is a relatively new phenomenon,” says Andrew Rundle, associate professor of Epidemiology and co-director of the Obesity Prevention Initiative. “As more adults transition into senior citizenship, we see obesity becoming a bigger factor in their lives.” 

Rundle explains that what’s happening is akin to a domino effect: as each birth cohort gets more and more obese, the distribution of obesity creates waves of higher prevalence overall. An estimated 10,000 Baby Boomers turn 65 every day; by 2030, there will be roughly 72.1 million Americans in their golden years. This trend is already beginning to have a real impact on the health of obese older adults and those who care for them.

According to the New York Times, nursing homes are struggling to keep up with the demands for larger beds, wheelchairs, and other special equipment—items that typically are more expensive and not covered by Medicaid (the largest payor of nursing home care).

Ruth Finkelstein, assistant professor of Health Policy and Management, says obesity is the single best predictor of high healthcare costs in the overall population. And those expenses continue to balloon for the aging population, which rely heavily on publically financed health coverage—Medicare and Medicaid, supplemented by private insurance and family support.

Another challenge is stigma and discrimination, the brunt of which is directed against those with grades two and three obesity. Seniors tend to become isolated from society, especially after retirement, which puts them at greater risk for mental health problems. Neither the Americans with Disabilities Act nor other protection guarantees people who are obese the services or equipment they require.

When coupled with obesity, aging adults are also at greater risk for diabetes, heart disease, cancer and other physical disabilities like weak knees and bad hips. This situation can become a vicious cycle, stemming from the fact that being obese also makes it harder to be more physically active.

To mitigate some of the health issues associated with obesity in older adults, experts say we need to provide environments, education, and services that address the problem. Finkelstein, also associate director of the Robert B. Butler Columbia Aging Center, has worked to get seniors outside of the home with better benches, safer crosswalks, and senior hours in public pools.

“When aging populations have meaning and purpose in their lives, are socially connected, and are going places and doing things—they can change specific health-related behaviors,” she says.

Studies show that a systemic approach seems to be most effective. Instead of solely concentrating on individual interventions like diet and exercise, we need to create environments that contribute to a person’s overall wellbeing.

Still, many more questions are bound to emerge with the coming boom in obese seniors.

“This is just the tip of the iceberg,” says Finkelstein.