As people live longer, more older adults are dealing with obesity, which can lead to heart problems, weakness, and loss of independence. European obesity experts have updated their guidelines for helping people aged 65 and older manage their weight in a safe way. Instead of just focusing on the number on the scale, doctors should look at muscle mass, strength, and overall quality of life. The best approach combines modest eating changes, exercise, support from healthcare teams, and sometimes medications—all designed to keep older adults strong and independent rather than just thin.

The Quick Take

  • What they studied: How obesity affects older adults (age 65+) and the best ways to treat it while keeping them healthy and independent
  • Who participated: This is a position statement summarizing research on older adults worldwide; it’s not a single study with participants but rather expert guidance based on many studies
  • Key finding: About one in three older adults worldwide has obesity, and treating it requires a personalized approach that focuses on keeping muscles strong and maintaining independence, not just losing weight
  • What it means for you: If you’re 65 or older and dealing with extra weight, talk to your doctor about a plan that includes healthy eating, exercise, and support—rather than extreme dieting that could make you weaker

The Research Details

This is a position statement from the European Association for the Study of Obesity, which means it’s a comprehensive review and update of expert recommendations rather than a new research study. The experts looked at all available scientific evidence about obesity in older adults and created practical guidelines for doctors and patients. This type of document summarizes what we know from many different studies and provides clear recommendations based on the best current evidence. It updates their previous guidelines from 2012 to include newer research and understanding about how aging affects weight and body composition.

Position statements like this are important because they help doctors provide consistent, evidence-based care. Older adults have different needs than younger people—their bodies change with age, they often take multiple medications, and they’re at higher risk for losing muscle mass. A one-size-fits-all approach to weight loss doesn’t work well for this group, so having clear, expert guidance helps ensure older adults get safe, personalized treatment.

This comes from a respected European organization of obesity experts and represents a consensus of current scientific knowledge. However, it’s a summary of existing research rather than new original research, so it’s only as strong as the studies it’s based on. The recommendations are practical and designed for real-world use by doctors and patients.

What the Results Show

The statement confirms that obesity is very common in older adults—affecting up to one-third of people aged 65 and older, though rates vary depending on where people live and their sex. As people age, their bodies naturally change in ways that make it easier to gain fat and harder to keep muscle, especially if they become less active or take certain medications. The key finding is that treating obesity in older adults requires looking at much more than just weight. Doctors should assess muscle mass, fat distribution, strength, mental health, and how well older adults can do daily activities. Weight loss alone isn’t the goal—maintaining strength, independence, and quality of life are equally important.

The statement emphasizes that the best treatment approach combines several strategies working together: eating a healthy diet with enough protein to protect muscles, doing structured exercise that includes both strength training and aerobic activity, getting behavioral support and counseling, and when appropriate, using obesity medications or considering weight-loss surgery. The focus should always be on what helps the individual older adult stay independent and healthy, not just on reaching a certain weight.

This updates the EASO’s 2012 guidelines with newer research and understanding. The major shift is recognizing that older adults with obesity often have a condition called ‘sarcopenic obesity’—where they have excess fat but also weak muscles. This changes how doctors should approach treatment, moving away from aggressive weight loss toward a more balanced approach that protects muscle while reducing excess fat.

This is a position statement based on existing research rather than a new study, so its strength depends on the quality of research it summarizes. The statement notes that obesity prevalence varies significantly by geography and sex, so recommendations may need adjustment for different populations. Individual older adults have very different health situations, so these general guidelines need to be personalized by healthcare providers who know each patient’s specific circumstances.

The Bottom Line

If you’re 65 or older with obesity: (1) Work with your doctor to create a personalized plan rather than following generic weight-loss advice—High confidence; (2) Include adequate protein in your diet and do regular exercise, especially strength training—High confidence; (3) Focus on staying strong and independent rather than reaching a specific weight—High confidence; (4) Consider behavioral support or counseling as part of your plan—Moderate confidence; (5) Discuss medications or surgery only after trying lifestyle changes and if your doctor recommends it—Moderate confidence.

These recommendations are specifically for adults aged 65 and older. Younger adults with obesity should follow different guidelines. Family members and caregivers of older adults should also understand this approach. Healthcare providers treating older adults should use these recommendations to guide their care. People with certain conditions (like severe malnutrition or advanced frailty) may need modified approaches that their doctor should discuss with them.

Improvements in strength and function may take 8-12 weeks of consistent exercise and healthy eating. Weight loss, if it occurs, typically happens gradually over months. The goal is sustainable changes that last years, not quick results. Some people may not lose much weight but still gain strength and independence—which is a success with this approach.

Want to Apply This Research?

  • Track weekly: (1) Days you did strength exercises, (2) Days you did aerobic activity, (3) Grams of protein eaten daily, (4) How you felt doing daily activities (stairs, walking, getting up from chair). Don’t focus only on weight—track these other measures of health.
  • Set a specific, achievable goal like ‘Do 2 strength training sessions this week’ or ‘Add protein to every meal’ rather than ‘Lose 10 pounds.’ Use the app to log exercise sessions and meals with protein content. Get reminders for exercise days and meal planning.
  • Monthly check-ins: Review your exercise consistency, protein intake patterns, and how your strength and daily activities are improving. Every 3 months, assess whether you’re maintaining or building muscle (ask your doctor about body composition testing). Adjust your plan based on what’s working, not just on scale weight.

This position statement provides general guidance for healthcare professionals and older adults managing obesity. It is not a substitute for personalized medical advice from your doctor. Older adults have individual health situations, medications, and conditions that require customized treatment plans. Before starting any weight loss program, exercise routine, or medication, consult with your healthcare provider. This is especially important if you have heart disease, diabetes, take multiple medications, or have concerns about malnutrition or frailty. The goal of obesity management in older adults should always be to improve health and independence while minimizing risks—your doctor can help determine the right approach for your specific situation.