Obesity in the elderly: peculiarities of treatment in outpatient practice

Today there is a worldwide trend of population aging, in addition, the proportion of older people with obesity is increasing. In order to adequately manage these patients in the outpatient setting, it is critical to understand the dynamic relationship between body weight, chronic disease prevalence, development of functional disability, life expectancy, and health care costs. While the obesity epidemic has affected people of all age groups, empirical knowledge about the management of obese older people remains largely scarce. Currently, there is no single therapeutic approach to this problem. Weight loss should be treated with caution in people over 60 years of age. The risk of sarcopenia, malnutrition, bone loss, increased risk of falls and injury must be considered, which can lead to an increase in the number of people with disabilities and the associated costs of medical and social care. The analytical review focuses on the relationship between two of the greatest epidemiological trends: aging and obesity. This paper highlights the features of the pathophysiology of obesity in the elderly, the phenomenon of the «obesity paradox». Also from the perspective of evidence-based medicine approaches to the treatment of obesity in the elderly, including surgical interventions aimed at reducing body weight, are analyzed.