Raise your hand if you’ve spent way too many years (decades?) worried about your weight. For far too many, concern about one’s weight, weight gain, or inability to lose weight has been an all-consuming source of anxiety and distress. Apparently, on any given day in the United States, it’s been estimated that 17% of the adult population is on a diet. In fact, as one researcher declared, “Dissatisfaction with one’s weight is so widespread that experts consider it a global health concern.” The concern is understandable. Obesity rates have been on the rise for decades, chronic disease related to excess weight (cardiovascular disease, diabetes, and cancer, for example) is associated with serious illness (and high medical costs), and societal norms and pressure continue to attach stigma to those whose weight appears above “normal.” In fact, obsession with weight loss has been heightened in recent months with the availability of a new class of drugs that offer significant results in weight loss but, due to abusive use by those who don’t really need the drugs, and because of their high costs which insurance may not cover, it may mean these new medications are not available for most people who could benefit. 

So how much of your time should you spend worrying about your weight, especially as you get older? In fact, there is some thought in the scientific and medical communities that less time should be spent worrying about weight as you age and more time should be spent on changing what we eat and how we manage health with exercise and other behavioral changes, such as better sleep and stress reduction. Being overweight or even obese is not automatically the equivalent of being unhealthy. While excess weight has been implicated in sleep apnea and osteoarthritis, lifestyle changes (whether or not they lead to weight loss) will improve your health in ways that dieting and losing weight will not. For more on this line of thinking, click here. In fact, when it comes to weight in older adults, it’s not so clear that standards applied to younger people are relevant. While being drastically underweight or overweight has definite health implications, it appears that for older adults, carrying around a few extra pounds may not be a serious health concern (though fat specifically around the belly can have concerning health implications, including the risk of type 2 diabetes and heart and liver disease).

If anything, the opposite concern may be true for older adults. That is, weight loss as you get older could be a source of concern and a signal that something is seriously wrong. In a recent study published in JAMA Network Open, researchers determined that unintentional weight loss among healthy older adults could put such adults at risk of premature death. Studying close to 20,000 older adults in the United States and Australia, all of whom were healthy at the start of the study, researchers found that those who experience a weight loss of 5% of their body weight were at higher risk for mortality compared to those who did not lose weight (for men, the risk was 33% higher and for women, 26% higher). The conclusion? “Even a small weight loss of 5%, especially in the absence of any evident disease, can significantly increase the risk of mortality,” in older adults. While this was not a controlled experiment to determine if weight loss is the direct cause of the increased risk of death, it does underscore that any unintentional weight loss among older adults could be a warning sign and should be taken seriously. It should also be noted that weight gain among healthy older people showed no association with premature death. So, perhaps, finish up that slice of cake and then click here for more on this study.