Obesity is a major health concern worldwide causing increased morbidity and mortality and high cost for the society. The increase in the prevalence of obesity affects all age groups. Over the last several decades, the worldwide elderly population has expanded dramatically and geriatric obesity has become a growing global health issue, except among centenarians who have a low prevalence of obesity. In the US, the prevalence of geriatric obesity using body mass index (BMI) criteria is similar to the prevalence of non-geriatric obesity (> 30%). With aging, there is a gradual increase in mean body weight with fat mass (mainly visceral fat) increasing and non-fat mass (mainly muscle mass and bone mass) decreasing. There is also a decrease in height. Old subjects tend to have low food intake and limited physical activities. The decreased muscle mass (sarcopenia) is a significant factor causing functional limitations. Due to the high prevalence of sarcopenia in old subjects, BMI is not a reliable marker for the diagnosis and follow-up of geriatric obesity as it may not accurately reflect the fat mass. In general, obesity is managed with multidisciplinary approaches including lifestyle (e.g., diet, exercise, and behavioral change), food supplements, drugs, medical devices, gut microbiome modulation, body contouring, and bariatric surgery. However, in the elderly population, the management of obesity is a medical challenge and weight loss intervention is a controversial topic. Although weight loss may have several health benefits, because of its potential detrimental impact on muscle mass (sarcopenia) and bone mineral density (osteopenia), in several cases treatment strategies should focus on improvement of dietary habits and physical fitness/function and maintenance of body weight rather than weight loss.

Hassan M Heshmati, Medical Doctor, Endocrinologist, has 48 years of experience in clinical research in both Academia (University-Affiliated Hospitals, Paris, France and Mayo Foundation, Rochester, MN, USA) and Pharmaceutical/Biotech Companies (Sanofi, Malvern, PA, USA, Essentialis, Carlsbad, CA, USA, and Gelesis, Boston, MA, USA). His research activity has been related to pituitary tumor, hyperthyroidism, thyroid cancer, osteoporosis, diabetes, and obesity. He has extensive knowledge in the development of anti-obesity products. He is the author of 325 abstracts, book chapters, and articles related to Endocrinology and Metabolism. Currently, he is Consultant at Endocrinology Metabolism Consulting, LLC, Hassan Heshmati and Valerie Shaw Endocrine Research, Anthem, AZ, USA.