Weight is a very complex issue. For older people, the health problems associated with obesity may take a back seat to problems associated with body composition (fat-to-muscle ratio) and location of fat (hip or waist) on the body.

Many health problems are connected to being overweight or obese. People who are overweight or obese are at greater risk for type 2 diabetes, high blood pressure, heart disease, stroke, some types of cancer, sleep apnea, and osteoarthritis. But data show that for older adults, thinner is not always healthier, either. In one study, researchers found that older adults who are thin (a body-mass index or BMI of less than 19) have a higher mortality rate compared with those who are obese or of normal weight. In another study, women with low BMI had an increased risk of mortality. Being, or becoming, thin as an older adult can be a symptom of disease or an indication of developing frailty. Those are possible reasons why some scientists think maintaining a higher BMI may not necessarily be bad as we age.

Body-fat distribution, specifically waist circumference and waist-to-hip ratio, can also be a serious problem for older adults. We know that the "pear" shape, with body fat in peripheral areas such as the hips and thighs, is generally healthier than the "apple" shape, with fat around the waist. Being apple-shaped can increase risk for heart disease and possibly breast cancer. With age, the pattern for body fat can shift from safer peripheral areas to the abdominal area of the body. BLSA researchers examined 547 men and women over a 5-year period to observe body measurement changes. They found that men predominantly shifted in waist size, while women showed nearly equal changes in waist and hip measurements. The men developed a more dangerous body-fat distribution, even though women carried more total body fat. This may help explain why men generally have a higher incidence of certain diseases and a shorter lifespan.

So, is there a "normal" weight range or pattern for healthy aging? For older adults, one size does not fit all. Although we have learned a lot about patterns of weight and aging, watching your weight as you age is very much an individual matter. Talk with your doctor about any weight concerns, including decisions to lose weight or any unexplained weight changes.

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