Overweight and Over Sixty

Why taking the pounds off can be more difficult — but well worth it.

By Sheila Buff

People with type 2 diabetes are always being urged to lose weight if they're overweight of obese. But as you get older, losing weight safely becomes more of a challenge. Even so, it's worth doing. Losing between 5 and 10 percent of your body weight will probably help improve your blood sugar numbers and bring your blood pressure down without adding any drugs.

Lose Weight, Lose Strength?

Our bodies inevitably change as we age. We swap some of our muscle mass for more body fat, while also losing some of our bone mass, and our metabolism just slows down. We need fewer calories than we used to, and when we gain weight it's harder to lose than ever. However, because dieting causes some loss of lean muscle and can also reduce your bone mass, sometimes doctors don't recommend it for older adults. They worry that you'll lose so much muscle and bone that you'll become frail.

Fortunately, that's a worry that most overweight adults can put to rest. A 2011 study in the New England Journal of Medicine showed that when overweight older adults combine moderate dieting and exercise, the benefits are powerful. In the study, the people who both dieted and exercised lost about 9 percent of their body weight but kept their lean muscle mass. They were stronger, had better balance, and could walk faster and longer than the people who only dieted or only exercised.

If you have physical ailments such as arthritis, losing weight can often help. Combining diet changes with an increase in physical activity may help even more. If you're having trouble getting around because of knee arthritis, for instance, losing a modest amount of weight can lead to big improvement. If you do safe exercises — water aerobics, for example — at the same time, your weight loss will happen a little faster and you'll gain strength.

Dieting and Bone Loss

One important consideration: Older women who lose weight by dieting seem to lose bone mass in their hips at a faster rate than women who don't diet. And some research has shown that for an older, overweight woman who loses weight by dieting, the risk of having a hip fracture may be twice that of an older woman whose weight stays the same, even if she's overweight.

Is the increased risk of fracture a reason to avoid losing weight? Possibly, but it needs to be balanced against the benefits of weight loss for your diabetes, arthritis, and any other chronic health problems. You may be able to reduce your risk of fracture while dieting by being sure to get plenty of protein, calcium, and vitamin D. Before you start dieting, talk to your doctor about your bone density and fracture risk.

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Last Modified Date: February 15, 2013

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by Brenda Bell
Many people say that depression is a side effect or complication of diabetes. Without discounting the association of the psychological condition with the physical one, I'm not convinced that our high and/or unstable glucose levels are directly responsible for that change in our mental state. My belief is that the unrelenting need for self-care, for following the sort of care schedules that can drive licensed, professional caregivers crazy, is what overwhelms us...
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