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Anthony Cirillo

Overweight Seniors May Live Longer

By February 20, 2013

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Body weight does not necessarily correspond to longevity. According to a new report in the Journal of the American Medical Association (JAMA), those carrying extra pounds outlive their thinner peers and those who were overweight at ages 65 and older, even those who were highly obese, had a lower mortality rate.

In an editorial coinciding with the paper, Steven Heymsfield, M.D., executive director of the Pennington Biomedical Research Center in Louisiana, wrote that overweight people whose indicators such as cholesterol "are in the abnormal range, then that weight is affecting you." He added that if indicators are normal, there's no need to "go on a crash diet."

Experts suggested that concepts of fat and the body mass index (BMI), which provides a ratio of height to weight should be revised. However, those in the highest obesity categories of BMI remained at high risk.

One possible factor for the findings is that the overweight or somewhat obese are already being treated for weight-associated conditions such as high cholesterol or diabetes. Some suggested fat could be protective in some cases. But experts were quick to say that individuals should not try to gain excessive weight to live longer.

I am trying to make sense of this. Despite years of warning to control our weight, are we now saying in essence, well if you don't take care of yourself than the medical profession will be forced to care for you and once we get your risk factors under control, even if you are still technically overweight, no worries, you will lead a long, quality life.

I have contended that many do not take self-responsibility for their health because they feel at the end of the day there will be a pill, procedure, device, implant, whatever that will save them. In the meantime, health care costs skyrocket and we all suffer from increased premiums. Studies like this one just reinforce that it is OK to not take care of ourselves.

Many of our seniors suffer from malnutrition so getting them to eat properly, in essence fattening them up a bit, is a good thing. There is such a thing as a healthy weight. It means neither being too skinny or excessively overweight. As with everything else, moderation is in order.

Of course we have a health system that still rewards more not less so we are more than happy to heap on additional services for people instead of teaching our patients and communities how to exercise self-responsibility.

Many seniors would simply benefit from getting to a healthy weight. In a recent article in Medical Home News, I addressed the senior hunger issue.

There is a link between good nutrition, health, and the ability of seniors to live independently in their own homes.

  • Good nutrition promotes and supports good health. Poor nutrition on the other hand leads to poor health, and poor health is extremely costly not only in personal terms for the individuals who suffer from it but also for the Nation and our economy.
  • If we leave frail seniors, who cannot properly cook or go shopping, in their homes without proper nutrition, their health will inevitably fail. If they survive, they will end up hospitalized or institutionalized at a cost to the government that far exceeds the cost of providing adequate funds to Senior Nutrition Programs to enable them to furnish seniors meals in the homes and other settings.
  • Seniors at risk of hunger are significantly more likely to be in poor or fair health than the general senior population. Senior Nutrition Programs can provide meals to an individual for a year for roughly the cost of one Medicare day in the hospital or ten days in a nursing home.
  • Seniors experiencing food insecurity have the same chance of an activities of daily living (ADL) (bathing, getting dressed, going to the bathroom, etc.) limitation as someone several years older. That is, there is in effect a large disparity between actual chronological and "physical" age. For example, a 64-year-old senior suffering from hunger is likely to have the ADL limitations of an 85 year old. According to prior research by the Meals On Wheels Research Foundation, 65 percent of food secure seniors suffer from at least one ADL limitation; 88 percent of food insecure seniors suffer from at least one ADL limitation.

Let's address senior hunger and not debate the merits of being overweight as we age.

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