AWM: Weight Management for Older Adults 2014
Click here to see the explanation of recommendation ratings (Strong, Fair, Weak, Consensus, Insufficient Evidence) and labels (Imperative or Conditional). To see more detail on the evidence from which the following recommendations were drawn, use the hyperlinks in the Supporting Evidence Section below.
AWM: Weight Management for Older Adults
For older adults (aged 65 years and older) who are overweight or obese, the registered dietitian nutritionist (RDN) should provide medical nutrition therapy (MNT) for weight loss and weight maintenance. Research has reported reduced risk of mortality, reduced development of type 2 diabetes and improved cardiovascular risk factors with intentional weight loss in older persons and weight gain produces increased risk for several health outcomes.
Risks/Harms of Implementing This Recommendation
Conditions of Application
This recommendation applies to older adults who are overweight or obese.
Potential Costs Associated with Application
Costs of MNT sessions vary, however MNT sessions are essential for improved outcomes.
From the 2010 Dietary Guidelines Advisory Committee (DGAC) Nutrition Evidence Library (NEL) Evidence-Based Systematic ReviewsFor older adults (age older than 65), what is the effect of weight loss vs. weight maintenance on health outcomes (cardiovascular disease, type 2 diabetes, cancer and mortality?
- Weight loss in older adults has been associated with an increased risk of mortality, but because most studies have not differentiated between intentional and unintentional weight loss, recommending intentional weight loss has not been possible. Recently however, moderate evidence of a reduced risk of mortality with intentional weight loss in older persons has been published. Intentional weight loss among overweight and obese older adults, therefore is recommended. In addition, with regard to morbidity, moderate evidence suggests that intentional weight loss in older adults has been associated with reduced development of type 2 diabetes and improved cardiovascular risk factors. There are insufficient data on cancer to come to a conclusion. Weight gain produces increased risk for several health outcomes.
Recommendation Strength Rationale
The Conclusion Statement for Energy Balance and Weight Management, Older Adults in support of this recommendation received a grade of Moderate.
- Risks/Harms of Implementing This Recommendation
The recommendations were created from the evidence analysis on the following questions. To see detail of the evidence analysis, click the blue hyperlinks below (recommendations rated consensus will not have supporting evidence linked).
References not graded in Academy of Nutrition and Dietetics Evidence Analysis Process
2010 Dietary Guidelines Advisory Committee (DGAC) Nutrition Evidence Library (NEL) Evidence-Based Systematic Reviews. Available at http://www.nutritionevidencelibrary.gov/category.cfm?cid=21.