It’s been called a public health epidemic and looking at the data it’s not hard to see why. With estimates that by 2030 one in two US adults will be obese and with consistently rising weight gains reported, the implications for the health of our country (and our aging adults) are distressing.  Because the heavier you are during middle age the more likely you will suffer chronic health problems after age 65. According to a recent study published in JAMA Network Open, the heavier you are at age 40, the greater your odds of health challenges as an older adult. And, those considered obese, especially severely obese, live an average of 5 years less than those of normal weight. So the consequences of weight gain are substantial- and the more you can do to prevent or limit weight gain, the better off you will be. For more on the definitions of obesity and the health risks that can accompany it, step off the scale and click here.

So it’s no surprise then that the Women’s Preventive Health Services Initiative has just released recommendations for counseling women in mid-life who are of normal weight or overweight on how they can prevent or limit further weight gain, with the goal of optimizing their health in the years going forward. Included in the recommendations for clinicians are personalized conversations with each woman about her individual dietary and exercise patterns, in order to proactively prevent obesity. As the lead researcher on these recommendations, Dr. Amy Cantor, made clear, “Despite high prevalence rates of obesity in the United States, no clinical guidelines exist for obesity prevention in midlife women who commonly experience weight gain.” This is especially important given that, as one expert makes clear, “Women are at higher risk for severe obesity due to menopause and age-related physiological changes. Significant weight gain is associated with a serious risk of developing cardiovascular disease, hypertension, Type 2 diabetes, fatty liver disease, and numerous cancers. That is why advising middle-aged women with normal to overweight BMI on the need to limit weight gain is critical.”

But these recommendations do not come without some criticism. Losing weight is not an easy proposition for anyone (nor is keeping weight off once lost), especially for women whose weight problems do not stem from a lack of willpower but from other life challenges, such as insufficient access to healthy food, inadequate time for exercise, or other socioeconomic challenges. There are a growing number of weight loss medications coming to market, but for many, insurance coverage is nonexistent or inadequate (apparently Medicare drug plans routinely refuse to cover these medications), so gaining access to what could be life-saving medication is not readily available. There appear to be a growing number of telemedicine/online options for gaining access to weight loss medications, but those, too, have limitations (not enough monitoring or oversight) and present sufficient risk. Consumers need to be cautious about accessing medications through these sites, no matter how beneficial it would be to lose weight. So, while we know that more and more of our population are at considerable health risk due to rising rates of obesity, as a country we have not yet figured out how to address this- to the detriment of our public health and the health and lives of millions of older adults.