Ellie Rahman
Contributor
In 2019, frailty was declared a medical condition characterized by a progressive decline in physiological function and increased vulnerability to adverse health outcomes. Alarms were raised after the recent health crisis revealed that frail older adults accounted for approximately 51% of hospitalized patients with COVID-19. This established frailty as a potentially life-threatening condition.
Since then, plenty of research has been conducted on the risk factors of frailty. In 2023, a particular study piqued the interest of the medical community. This was after conclusive evidence revealed a close link between frailty and obesity. This implies that adults with higher body mass index (BMI) are at higher risk of experiencing frailty when older. Let’s take a closer look below.
Obesity and frailty
The aforementioned study, published in the journal BMJ Open, was conducted by researchers from the University of Oslo, Norway. Here, they took a look at the BMI of 4509 people aged 45 and older from 1994−2016. Their findings, published in January 2023, highlighted that people who had obesity in 1994 were almost 2.5 times as likely to be ‘pre-frail or frail’ by 2016 than those with a normal BMI.
Obesity can contribute to the development of frailty through various mechanisms. Excess weight can exacerbate the decline in muscle strength and physical capacity that occurs as one gets older by placing greater stress on the joints and bones. Additionally, excessive adipose tissue produces inflammatory substances called adipokines, which can promote a chronic state of inflammation in the body. This inflammation has been linked to the acceleration of age-related declines in physical function and muscle strength, leading to frailty.
Furthermore, obesity is often accompanied by insulin resistance. This is a condition where the body’s cells become less responsive to the hormone insulin. Insulin resistance can impair muscle protein synthesis and contribute to muscle wasting, a hallmark of frailty.
Obesity and other health conditions
Obesity has historically been linked to other health conditions besides frailty. In our previous article on dementia, for instance, we noted how obesity is one of the nine risk factors accounting for much of the world’s dementia. This has been supported by various other research studies that show an association between BMI and cognitive function in older adults. Obesity-related comorbidities, such as cardiovascular diseases, diabetes, and osteoarthritis, further contribute to physical limitations and functional decline in older adults. These conditions can exacerbate the effects of obesity on physical function and increase the risk of developing frailty.
Treatment and prevention of obesity
Managing obesity in older adults can help reduce the risk of frailty and improve overall health outcomes. Strategies should focus on lifestyle modifications, including a balanced diet and regular physical activity. Those who are struggling to keep weight off, however, should consider medical treatments. Medication addresses underlying biological mechanisms that could be hindering your weight loss process. These include your leptin gene or insulin resistance.
It is crucial that you consult with your doctor on treatment plans to avoid misinformation on the Internet. Case in point: many in the weight loss community have become confused about the usage of GLP-1 for weight loss because of rumors of celebrities using Ozempic, a diabetes treatment containing the GLP-1 semaglutide, to lose weight. However, the only medication that contains semaglutide and is FDA-approved for weight loss is Wegovy. If you’re planning on using weight loss pills as part of your treatment, it’s best to let your doctor assess your medical history and determine the best anti-obesity medication for you to pair with a holistic weight loss plan.
If your weight loss attempts with supervised diets and exercise programs are unsuccessful, you may also be recommended to undergo bariatric surgery. Many elderly patients have been found to enjoy satisfactory postoperative weight loss. However, it is key to note that older age had a higher recovery time and lower comorbidity resolution than younger patients. This can affect an already frail patient; hence bariatric surgery should be offered earlier in life to reap its benefits.
There are plenty of ways to treat obesity and even treat frailty, so don’t hesitate to consult your medical provider. By addressing obesity early, you can enjoy a higher quality of life in your senior years.
We appreciate Ellie Rahman for this informative article.
Dr. Joe Casciani is the owner and Chief Curator for the Living to 100 Club, a source of solutions to living longer and healthier, with a special focus on mindset and attitudes about aging. He has a 40-year history as a psychologist and manager of mental health practices specializing in behavioral health services with older adults. In addition to his work as a clinical consultant, he is an engaging and inspiring speaker, and helps audiences move beyond their questions and concerns about aging to create a vision of what is possible in the years ahead. He strongly believes there is value in helping people feel inspired about their future.