Take a personalised approach to weight management for older adults with obesity

Prevalence of obesity is increasing among older adults worldwide. Careful consideration of the risks and benefits of treatment, alongside patient priorities, should guide selection of all weight management strategies in older adults. Weight loss is recommended for obese older adults, while overweight patients are recommended to maintain a stable body weight. Physical exercise and nutritional support are essential to avoid progression of sarcopenia. Pharmacological weight-loss medications, including liraglutide, semaglutide, tirzepatide, orlistat and naltrexone/bupropion, are available as adjunct therapy, although clinical data in older adults is limited. Bariatric surgery should be reserved for patients who have not responded to behavioural interventions or pharmacological treatments, as the risks of adverse outcomes are significantly higher with older adults.