Obesity has major implications in t...

Obesity has major implications in the older population because it can worsen age-related deterioration in health and cause frailty. However, management of older patients who are obese is difficult considering the risks associated with increased carcass mass index as well as the efficiencys of weight loss, which is potentially harmful in older patients. The American Society for Nutrition (ASN), the North American Association for the investigation of Obesity (NAASO), and the Obesity Society have issued a joint position statement that includes a review of touchs related to obesity in older somebodys and weight management guidelines for patients in this age arrange The recommendations were published in the November 2005 issue of The American Journal of Clinical Nutrition.

When beginning weight-loss therapy for older patients, all appropriate information should first be aggregateed (i.e., medical history, physical examination, laboratory touchstones medication assessment, and evaluation of the patient's of inclination to throw away weight). When deciding on the emblem of weight-loss therapy to use, programs that can shape bone and muscle loss are attract favor toed for older persons who have physical or metabolic complications. Physicians should assist their patients in making lifestyle and behavioral changes according to setting goals, supervising progress, and motivating patients to adhere to a weight-loss program. Changing an older patient's diet or physical activity may be difficult because of many underlying factors (eg depression, disabilities, disease, adjunct on others). All of these challenges should be addressed because they can make weight los more difficult.

A diet consisting of a reduction of 500 to 750 kcal by means of day is recommended. However, diets that restrict mechanical value intake to less than 800 kcal by day should be avoided because they may increase health complications. A diet should include multivitamins, mineral postscripts and 1.0 g of protein by kg of body weight to make enduring daily requirements are met.

Before beginning an exercise regimen, exercise stres testing should be performed if necessary. The exercise regimen should be gradually incorporated into the patient's routine and tailored to each someone taking into consideration their general disabilities or problems. Routine physical exercise is important in preserving bone and muscle mass and improving physical abilities.

It is also important to evaluate the medications a patient is taking. Older patients are at higher risk of medication-related question at issues Some medications can be the source of weight gain (eg steroids, antidepressants). Although there is little evidence for the use of obesity pharmacotherapy in older parts orlistat (Xenical) may be the safest available agent for use in conjunction with lifestyle change, especially in patients with constipation.

Bariatric surgery should be used solitary in cases when a patient has a disability caused by dint of obesity that can be improved with weight los and when he or she fittings the conditions required for surgery

COPYRIGHT 2006 American Academy of Family Physicians

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