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University of Adelaide. “Gen X obesity a major problem for healthcare, workforce: Australian study.” ScienceDaily. ScienceDaily, 27 March 2014.
You may sometime hear about grandpa that smoked all his life and is still doing just fine. It doesn’t mean that smoking does not affect people’s health. While everybody else has died from cancer or other lung diseases at a younger age, grandpa is now older and doing well while still smoking like a chimney, as he may just happen to have a sort of resistance to the harmful effects of smoking. This may explain the “obesity paradox” and why some older adults affected by obesity seem to do better than their normal weight counterparts. This said, there is no final word on whether overweight and obesity are protective in the older population and more studies are needed. Nevertheless, reluctance is sometimes seen in implementing weight-loss regimens in the elderly, and it may be due at least in part to these uncertainties.
A good night’s sleep: Deep rest helps the entire body function properly. Sleep modulates neuroendocrine function and glucose metabolism. Poor quality sleep can result in metabolic alterations such as glucose intolerance and a variation in the appetite-regulating hormones.
Currently, 7% of world’s population is over 65 years of age. This figure is projected to rise to 12% by 2030. In the US it is projected to rise from 12% (35 million) to 20% (71 million) by 2030 (Yan et al., 2004). These substantial increases among older adults suggest that obesity among older Americans is likely to become a greater problem in the future (Center on an Aging Society, 2003). By 2000, the prevalence of obesity in people 50 to 69 years of age had increased to 22.9%, and for those above 70 years of age to 15%, representing increases of 56% and 36% respectively, since 1991 (Villareal et al., 2005).
Baby boomers form the solid core of Dr. John Hernried’s practice as medical director of Sutter Weight Management Institute: His typical patient needs to lose more than 60 pounds, he said. But many of his boomer patients have been resigned to being heavy – and many more, even as they deal with diabetes and the prospect of knee-replacement surgery, are in denial as to what carrying extra pounds will do to their health.
The U.S. Food and Drug Administration approved orlistat capsules, branded as alli, as an over-the-counter (OTC) treatment for overweight adults in February 2007. The drug had previously been approved in 1999 as a prescription weight loss aid, whose brand name is Xenical. The OTC preparation has a lower dosage than prescription Xenical.
Weight-loss trials with adults 65 years and older that include mechanisms are few. These studies demonstrate that volume of exercise (particularly resistance training) appears critical in attenuating the loss of bone and muscle, along with calcium and Vitamin D supplementation. Inflammatory molecules and pathways, bone active hormones, exercise, mechanical unloading, sclerostin, and diet composition (glycemic index) all appear to be mediators in the response to weight loss.
The amount of stomach acid you produce decreases with age or certain medications. This may put you at risk for vitamin B-12 deficiency and symptoms like depression and fatigue. Supplements and fortified foods, such as orange juice, milk and yogurt are usually well-absorbed by your body.
There are a number of physical, psychological, and emotional issues that can arise as a result of obesity. In some instances the consequences of obesity can be life threatening, which is why excessive weight problems should be addressed as soon as possible. Some of the possible consequences of obesity include:
Another job vacancy associated with obesity might be one normally filled by a stomach bacterium called Helicobacter pylori. Research by Martin Blaser of New York University suggests that it helps to regulate appetite by modulating levels of ghrelin—a hunger-stimulating hormone. H. pylori was once abundant in the American digestive tract but is now rare, thanks to more hygienic living conditions and the use of antibiotics, says Blaser, author of a new book entitled Missing Microbes.
Jump up ^ Barness LA, Opitz JM, Gilbert-Barness E (December 2007). “Obesity: genetic, molecular, and environmental aspects”. American Journal of Medical Genetics. 143A (24): 3016–34. doi:10.1002/ajmg.a.32035. PMID 18000969.
Diuretic herbs, which increase urine production, can cause short-term weight loss but cannot help patients achieve lasting weight control. The body responds to heightened urine output by increasing thirst to replace lost fluids, and patients who use diuretics for an extended period of time eventually start retaining water again anyway. In moderate doses, psyllium, a mucilaginous herb available in bulk-forming laxatives like Metamucil, absorbs fluid and makes patients feel as if they have eaten enough. Red peppers and mustard help patients lose weight more quickly by accelerating the metabolic rate. They also make people more thirsty, so they crave water instead of food. Walnuts contain serotonin, the brain chemical that tells the body it has eaten enough. Dandelion (Taraxacum officinale) can raise metabolism and counter a desire for sugary foods.
If you are considered to be overweight, losing as little as 5 percent of your body weight may lower your risk for several diseases, including heart disease and type 2 diabetes. If you weigh 200 pounds, this means losing 10 pounds. Slow and steady weight loss of 1/2 to 2 pounds per week, and not more than 3 pounds per week, is the safest way to lose weight.
Lack of access to healthy foods. Some people don’t live in neighborhoods with supermarkets that sell healthy foods, such as fresh fruits and vegetables. Or, for some people, these healthy foods are too costly.
One of the two major types of diabetes, the type in which the beta cells of the pancreas produce insulin but the body is unable to use it effectively because the cells of the body are resistant to the action of insulin. Although this type of diabetes may not carry the same risk of death from ketoacidosis, it otherwise involves many of the same risks of complications as does type 1 diabetes (in which there is a lack of insulin).
• Functional. Decreased daily living skills and poverty negatively impact shopping and cooking. Poorly fitting, or lack of, dentures makes eating difficult. Caregiver neglect is another factor; the quality of the relationship between the person being fed and the feeder is a predictor of food intake.4 Loneliness and social isolation also are linked to decreased food intake.
Addressing the high rates of overweight and obesity within the baby boomers generation should be a policy priority. As this generation moves towards old age the significant associations between body mass index and chronic disease and disability promise to increase demand upon an already pressurized health system.
Dietary modification is the cornerstone of treating cardiovascular disease in older adults who are obese. Grundy (2004) has described obesity as a major underlying factor contributing to atherosclerotic cardiovascular disease (ASCVD) and a factor associated with multiple other ASCVD risk factors, including elevated blood pressure, hypertriglyceridemia, low high-density lipoproteins, high cholesterol, and high fasting plasma glucose. It is also a risk factor for type 2 diabetes. Even though there is a strong association between obesity and ASCVD, the relationship underlying the mechanism is not well understood. The fact that obesity acts on so many metabolic pathways, producing so many potential risk factors, makes it challenging to delineate the specific mechanism by which obesity contributes to ASCVD. Gundy suggested that the fundamental question for controlling cardiovascular diseases related to obesity is: how can we intervene at the public health level to reduce the high prevalence of obesity in the general population. He added that indeed, “This approach offers the greatest possibility for reducing the cardiovascular risk that accompanies obesity” (p. 2600). The widely disseminated Healthy People 2010 (U.S. Department of Health and Human Services, n.d.) challenges individuals, communities, professionals, and indeed all of us, to take specific steps to reduce obesity to ensure that good health, as well as long life, are enjoyed by all. Dietary modification is the cornerstone of treating cardiovascular disease in older adults who are obese. Interventions to decrease obesity are presented in the next section titled, “Interventions to Address Obesity.”
In some cases, weight-loss surgery, also called bariatric surgery, is an option. Weight-loss surgery limits the amount of food you’re able to comfortably eat or decreases the absorption of food and calories or both. While weight-loss surgery offers the best chance of losing the most weight, it can pose serious risks.
Results from the National Health and Nutrition Examination Survey (NHANES) showed that in 2011–2014, nearly 70% of U.S. adults age 20 years or older were overweight or obese and more than one-third (36.5%) were obese (3). In 1988–1994, by contrast, only 56% of adults aged 20 years or older were overweight or obese.
Along these lines, Gallup survey data also suggest a direct relationship between reported personal health status and reported personal weight situations among adults. Forty-two percent of those who say that their weight is “about right” also define their physical health as “excellent,” compared with just 13% of people who say that they are “very overweight.” People saying they are “very overweight” are more likely to describe their health as “fair” or “poor” (44%) than those who are “somewhat overweight” (24%), “about right” (15%), or “underweight” (27%).
The data showed that Sacramento boomers are more likely to be overweight than Californians living in every other part of the state except the San Joaquin Valley, where nearly four of every five boomers were overweight.
The history should also identify prescription and over-the-counter medications and herbal supplements that may be affecting appetite or contributing to weight loss. A social history focusing on alcohol and tobacco use and the patient’s living situation may elicit further useful information. The Mini Nutritional Assessment is a validated tool to help measure nutritional risk.22 The tool, which is available at http://www.mna-elderly.com/mna_forms.html, involves anthropometric measurements and general, dietary, and subjective assessments. Scoring allows categorization of older adults as well nourished (normal), at risk, or malnourished.22 The Nutritional Health Checklist (Table 4) is a simpler tool for assessing nutritional status that was developed for the Nutrition Screening Initiative.23
When working with obese clients, be sure that the equipment can accommodate their weight. Most manufacturers provide a weight limit in the product manual; if they do not, contact them to ascertain the weight limit for each piece of equipment that heavier clients will use. Free-weight exercises that require lifting dumbbells instead barbells from the floor to start an exercise may be easier. The width of the free-weight bar may also be too narrow to allow proper performance of exercises such as the biceps curl and back squat, indicating the need to use an Olympic-size bar, which is longer. Additional consideration should be given to selecting machine equipment that will be easy for overweight clients to get into and out of, and to avoiding some floor exercises (e.g., crunches, modified push-ups, stretching) that require clients to get down and up. If arthritis or joint pain is present, consider alternating the strength training exercises with lower-impact activities such as elliptical machines and stationary cycling activities or swimming. Regardless of the equipment used or the exercises being performed, programs for overweight and obese clients should include exercises that can be performed correctly and that clients feel more comfortable performing.
Many people who are overweight do not want to be overweight, obese, or ‘morbidly obese’. Everyone has his or her own story or circumstances concerning about how or why their body proportions are as they are.
Here’s the good news: Losing just 10% of your excess weight can reduce your chances of developing heart disease. If you are severely overweight and lose more than that, the benefits to your cardiovascular health increase considerably.
Identifying and avoiding food triggers. Distract yourself from your desire to eat with something positive, such as calling a friend. Practice saying no to unhealthy foods and big portions. Eat when you’re actually hungry — not simply when the clock says it’s time to eat.
Wilhelm’s father fit into that statistic. “Two days before my wedding, my father showed up, and this time he had a dramatic loss in weight,” she says, estimating that he lost an additional 30 pounds, adding to the 20 pounds lost in previous months. “I could not believe how frail he looked–I had never seen him this skinny. I could not believe the man looking at me was the father that used to put me on his shoulders when I was a little girl. I really had no idea what to do.”
Do you have a weight problem? If you do you are not alone. An average American gains between one-half pound to one pound every year. According to some estimates, almost one out of every 3 adults in the United States (about 97 million people) are classified as overweight or obese.
Over two-thirds of American adults are overweight or obese (National Health and Nutrition Examination Survey, 2004), with many estimates even higher (ACSM 2010). People must be more than 20 percent heavier than the recommended bodyweight for their height to be considered obese, yet bodyweight based on height chart assessments alone does not identify how much extra fat a person is carrying. Another method that does not identify body fat but rather uses bodyweight relative to height (kg/m2) is the body mass index (BMI). The National Institutes of Health (2007) use BMI values between 25 and 29.9 and those greater than 30 for classifying people who are overweight and obese, respectively. When skinfold measurements, or the more precise method of underwater weighing, are used to determine body-fat percentage, values that exceed the normal range by at least 5 percent are considered obese. In older populations, ACSM (2010) has suggested that satisfactory body-fat values for men and women age 50 to 59 are between 10 and 22 percent and 20 and 32 percent, respectively. Average body-fat values reported by the Cooper Institute for men age 60 to 69 and 70 to 79 are 22.6 and 23.1 percent, respectively, and those for women are 27.9 and 28.6 percent, respectively (ACSM 2010). Although girth measurements may also be used with older adults, they may not be as helpful because there are no well-established values for persons over 56 years of age. Regardless of the method used for assessing body composition, the lifestyles of many Americans clearly contribute to their weighing too much.
Most adolescents fall short of the Physical Activity Guidelines for Americans recommendation of at least 60 minutes of aerobic physical activity each day. Only 18% of students in grades 9—12 met this recommendation in 2007. Daily, quality physical education in school can help students meet the guidelines, however, in 2009 only 33% had access to and attended daily physical education classes.