Obesity in the Elderly Diabetic Patient

Obesity and type 2 diabetes constitute major public health issues in modern societies worldwide. Their prevalence on a global scale is alarming, and efforts to control their spread represent a priority of the public health agenda (1). Obesity is clearly driving a parallel epidemic of associated chronic diseases in all age-groups, including type 2 diabetes, hyperlipidemia, hypertension, atherosclerosis, obstructive sleep apnea, and liver dysfunction. Considerable attention is currently being focused on the consequences of obesity in vulnerable populations at both ends of the age spectrum, namely in youth and in the elderly. Elderly people, defined as individuals >65 years of age, comprise a substantial and growing part of the population in developed countries. Current demographic data in Western societies report that 12–15% of the general population is over the age of 65 years, and this proportion is projected to reach 20–25% by the year 2030 (2). Moreover, in the last 2 decades, the rate of obesity has risen dramatically among older adults, independently of sex, race, and educational level (3). This obesity epidemic significantly affects the health status of the geriatric population, since excess body weight in the elderly also correlates strongly with chronic ill health, poor quality of life, functional decline, disability, and dependency (4). Conversely, evidence suggests that obesity in the elderly is probably not associated with the same risks as in younger individuals, while in certain aspects, can even be protective (5). Furthermore, the prevalence of underweight is higher among older adults, who are also more vulnerable to unintentional weight loss either as a result of illness, or due to the aging process itself. The objective of this article is to assess the benefits relative to risks of weight loss that may be attained in the geriatric population, with special reference to the elderly diabetic patient. …