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Obesity and Overweight

Toolkit

Obesity in Older AdultsThe Gerontological Society of America KAER Toolkit for the Management of Obesity in Older Adults is intended to support primary care teams who seek to implement a comprehensive approach to help older adults with overweight and obesity recognize and care for their condition.

It includes practical approaches, educational resources, and validated clinical tools that teams can integrate into their workflows.

The toolkit was developed by GSA and supported by Novo Nordisk.

Updates to the Toolkit

July 2023 Updates 

  • Noted that care teams may find it useful to reflect on their current practices using the Start, Stop, Continue, Improve Action Plan. See page 4.  
  • Added resources from the Centers for Disease Control and Prevention and Health.gov regarding physical activity for older adults and from the LSU Pennington Biomedical Research Center about diet. See pages 61 and 62.
  • Highlighted the GSA Momentum Discussion Podcast episodes, Combating Bias to Promote Comprehensive Obesity Care for Older Adults and Kickstarting Body Size Conversations in Older Adults with Obesity. See pages 15 and 18, respectively.

March 2023 Updates 

  • Showcased a GSA Momentum Discussion webinar, "The GSA Toolkit for the Management of Obesity in Older Adults," featuring the expert peer review panelists for the Toolkit, who discuss the unique needs of older adults with overweight and obesity and provide valuable insights into using the Toolkit in clinical practice. See page 6.
  • Showcased a GSA Momentum Discussion Podcast episode, "Culturally Congruent Care for Hispanic Older Adults with Obesity," highlighting unique cultural beliefs and practices that are prevalent among individuals from the Hispanic community and offering valuable insights into how providers may provide culturally congruent care while using the GSA KAER Framework. See page 20.
  • Showcased a GSA Momentum Discussion Podcast episode, "Nutritional Needs of Older Adults with Obesity," exploring dietary needs of older adults and discussing the importance of assessing for and addressing sarcopenia. See page 44.

October 2022 Updates

  • Added a link to information about weight bias and stigma available from the UConn Rudd Center for Food Policy & Health. See page 15.
  • Added Walk with a Doc and exercise resources from the American Physical Therapy Association to Table R-1. Resources for Older Adults During the Body Size Journey. See page 55.
  • Added the American College of Sports Medicine’s Exercise is Medicine initiative, the Obesity Action Coalition’s Resource Library, and the World Obesity Federation to the Resources list. See pages 60 and 62.
  • Replaced the 2020 Trust for America’s Health State of Obesity report with the newly issued "State of Obesity 2022: Better Policies for a Healthier America."

GSA Publications

Obesity in Older AdultsOverweight. Obesity. Severe obesity. What do these terms mean, and how are people diagnosed with these conditions? What causes weight gain, and why it the situation worsening so quickly?

People’s body sizes have increased greatly over the past four decades. In 2017 and 2018, among Americans aged 60 years or older, 42.2 percent of men and 43.3 percent of women had obesity. This GSA publication reviews the evaluation, consequences, and clinical management of obesity and overweight in older adults.

Support for this publication was provided by Novo Nordisk.

Momentum Discussions

The GSA Toolkit for the Management of Obesity in Older Adults

November 10, 2022

The GSA KAER Framework—Kickstart, Assess, Evaluate, and Refer (KAER)—supports primary care teams to better meet the needs of older adults with obesity and overweight. Using this Framework with the tools and resources in the GSA Toolkit for the Management of Obesity in Older Adults, care teams can kickstart the discussion of weight with older adults and their families; assess the presence of altered body fat amount, distribution, and/ or function; evaluate the individualized care plans developed for older adults with overweight and obesity; and refer patients to community resources. During this Momentum Discussion, the expert peer review panelists for the Toolkit discuss the unique needs of older adults with overweight and obesity, review the need to address obesity and associated medical conditions intently, and provide valuable insights into using the GSA Toolkit for the Management of Obesity in Older Adults in clinical practice.

Panelists:

  • Rodolfo J. Galindo, MD, FACE, Associate Professor of Medicine Emory University School of Medicine Investigator, Center for Diabetes and Metabolism Research Emory University Hospital Midtown, Atlanta, Georgia
  • Joe Nadglowski, President/CEO, Obesity Action Coalition, Tampa, Florida
  • Fatima Cody Stanford, MD, MPH, MPA, MBA, FAAP, FACP, FAHA, FAMWA, FTOS, Associate Professor of Medicine and Pediatrics Harvard Medical School Obesity Medicine, Physician-Scientist Massachusetts General Hospital, Boston, MA
  • Kathryn N. Porter Starr, PhD, MS, RDN, Assistant Professor of Medicine–Geriatrics Duke University School of Medicine, Research Health Scientist Durham VA Health System, Durham, North Carolina
  • Jennifer Pettis, MS, RN, CNE, Director of Strategic Alliances, The Gerontological Society of America (Moderator)

Support for this Momentum Discussion was provided by Novo Nordisk.

Obesity: Its Effect on Increasing the Risk for COVID-19 and Other Health Conditions

November 2020

Obesity in older adults impacts morbidity and mortality, quality of life and increases the risk of institutionalization. Weight loss interventions can effectively lead to improved physical function. Diet-alone interventions can detrimentally impact muscle and bone physiology and without interventions to affect these elements, can lead to adverse outcomes. Understanding social and nutritional issues facing older adults is essential. This session will address the physiological changes that put older adults at risk for obesity and the specific impact of obesity on chronic health conditions, including COVID-19. The panelists will also discuss the impact of stigma associated with obesity and the role of an interprofessional team in ensuring the safety of older persons with obesity.

Panelists:

  • John A. Batsis, University of North Carolina at Chapel Hill, School of Medicine and Gillings School of Global Public Health (Moderator)
  • Shenbagam Dewar, Michigan Medicine, University of Michigan
  • Ted Kyle, ConscienHealth
  • Kathryn N. Porter Starr, Duke University School of Medicine and Durham VA Medical Center

Supported by Novo Nordisk.

Podcasts

People with obesity often experience bias due to their weight which can negatively impact their overall health and well-being. Older adults may have faced weight bias for many years, including from their healthcare providers, their families, and themselves. In addition to the weight bias being prevalent in healthcare, it also permeates places of employment, educational institutions, the media, and society overall. During this Momentum Discussion Podcast episode, Dr. Fatima Cody Stanford discusses weight bias and its negative consequences. She shares examples of how weight bias exists in healthcare and other areas and provides insights into how a person’s cultural identity impacts how they might experience weight bias. Finally, she offers solutions to this significant issue, including steps that healthcare professionals can take to eliminate weight bias and provide a comfortable environment of care for people with the chronic disease of obesity.

Guest:

  • Fatima Cody Stanford, MD, MPH, MPA, MBA, FAAP, FACP, FAHA, FAMWA, FTOS, Associate Professor of Medicine and Pediatrics, Harvard Medical School, Obesity Medicine Physician-Scientist, Massachusetts General Hospital

Host:

  • Jennifer Pettis, MS, RN, CNE, Director of Strategic Alliances, The Gerontological Society of America

This podcast episode is supported by Novo Nordisk. Content was developed by The Gerontological Society of America (GSA).

Kickstarting the obesity conversation with older adults requires an understanding of the pathophysiology of overweight and obesity in conjunction with an appreciation for communication concerns that affect conversations with older adults. In this podcast episode, Dr. Jason Lofton of Lofton Family Clinic and Wellness in De Queen, AR discusses important issues addressed in Step One of The GSA KAER Toolkit for the Management of Obesity in Older Adults: Kickstart the Obesity Conversation. He shares insights into how he and his team set the stage to engage in successful, motivating conversations about body size with their patients. Dr. Lofton discusses overcoming common roadblocks to body size conversations, preparing for shared decision making and goal setting, and how issues such as culture, race/ethnicity, and age influence conversations about body size. 

Guest:

  • Jason Lofton, MD, Lofton Family Clinic and Wellness

Host:

  • Jennifer Pettis, MS, RN, CNE, Director of Strategic Alliances, The Gerontological Society of America

This podcast episode is supported by Novo Nordisk. Content was developed by The Gerontological Society of America (GSA).

A chronic and often untreated disease, obesity has emerged over the past half century as a major source of morbidity and mortality in the United States and many other countries worldwide. Despite the recognition of obesity as a chronic disease, public policies limit access to a full range of obesity care services for many individuals who would benefit from comprehensive, interdisciplinary care for their disease—including older adults. In fact, within the Medicare population, reimbursements are available for intensive behavioral therapy and nutritional counseling provided by primary care physicians and for bariatric surgery. This GSA Policy Profile episode provides listeners with major policy initiatives currently being sought for comprehensive obesity care, addresses barriers to implementation of these initiatives, and provides valuable insights into how we care encourage policymakers to make addressing obesity a priority.

Guest:

  • Joe Nadglowski, President/CEO, Obesity Action Coalition

Host:

  • Patricia M. "Trish" D'Antonio, BSPharm, MS, MBA, BCGP, Vice President, Policy and Professional Affairs, The Gerontological Society of America

Additional resources: 

This podcast episode is supported by Novo Nordisk and was developed by The Gerontological Society of America (GSA).

It is vital that health care professionals supporting older adults on their weight loss journey recognize the importance of cultural differences as well as differences in risk based on age, race, or ethnicity. Cultural preferences and views about larger body sizes should also be respected. In this podcast episode, Dr. Rodolfo Galindo, an expert review panelist of the GSA KAER Toolkit on the Management of Obesity in Older Adults, highlights unique cultural beliefs and practices that are prevalent among individuals from the Hispanic community and discusses how providers must recognize and factor them into conversations about weight and obesity. He also notes how providers may provide culturally congruent care while using the GSA KAER Framework to kickstart the discussion of weight with older adults and their families; assess for the presence of altered body fat amount, distribution, and/ or function; evaluate treatment options; and refer patients to community resources.

Guest:

  • Rodolfo J. Galindo, MD, Associate Professor of Medicine, Emory University School of Medicine, Investigator, Center for Diabetes and Metabolism Research, Emory University Hospital Midtown

Host:

  • Jennifer Pettis, MS, RN, CNE, Director of Strategic Alliances, The Gerontological Society of America

Support for this podcast was provided by Novo Nordisk. The content was developed by The Gerontological Society of America.

We all experience normal physiological and metabolic changes as we age, including loss of muscle mass, that can impact functioning and quality of life. When combined with obesity or overweight, these changes can be magnified, causing even greater functional losses and decreases in quality of life. An all-too-often approach of simply limiting caloric intake to lose weight may further heighten these risks. As such, older adults seeking to lose weight need a balanced diet that will support loss of excess adiposity while preserving muscle. As vital members of the patient care team, dietitians can support older adults seeking to lose weight to ensure that their nutrient needs are met while on their weight loss journey. Additionally, these professionals can support the older adult to address social, environmental, and economic risk factors that often go unrecognized yet play an enormous role in healthy dietary patterns. In this podcast episode Dr. Kathryn N. Porter Starr, an expert review panelist of the GSA KAER Toolkit on the Management of Obesity in Older Adults, explores complex issues around dietary needs of older adults, including the importance of assessing for and addressing sarcopenia, and highlights how comprehensive nutritional care can support function, independence, and quality of life while enabling the older adult to reach and maintain their desired body weight.

Guest:

  • Kathryn N. Porter Starr, PhD, MS, RDN, Assistant Professor of Medicine–Geriatrics, Duke University School of Medicine, Research Health Scientist, Durham VA Health System, Durham, North Carolina

Host:

  • Jennifer Pettis, MS, RN, CNE, Director of Strategic Alliances, The Gerontological Society of America

Support for this podcast was provided by Novo Nordisk. The content was developed by The Gerontological Society of America.

The vexing problem of the increasing weight of Americans has grown to epidemic proportions in recent decades. As millions of people enter older adulthood, they bring with them added pounds and the challenges of excessive body fat. Now recognized as a chronic medical condition, obesity is associated with serious health problems that increase morbidity and mortality, stigmatization at work and in social settings, decreased physical function, lower health-related quality of life, and increased direct and indirect health care costs. When combined with common aging-related challenges, obesity can create complex clinical situations without easy solutions.

In this episode, Dr. Fatima Cody Stanford (Obesity Medicine Physician Scientist at Massachusetts General Hospital and Harvard Medical School) speaks with Dr. Tamara A. Baker (Professor in the Department of Psychiatry at School of Medicine, University of North Carolina at Chapel Hill), addressing the issue of obesity and specifically how the prevalence of obesity is different in communities of color versus majority communities in the United States. Dr. Stanford reviews the different factors that contribute to the high burden of obesity in racial and ethnic minority populations, why there appears to be worsened outcomes in patients who have obesity and COVID-19, and strategies that can be utilized to address excess weight in communities with high prevalence of obesity, especially in older adults.  The interview closes out with a review of barriers to receiving treatment and an overview of legislation has been proposed to help address the epidemic of obesity in our communities.

Guest:

  • Fatima Cody Stanford, MD, MPH, MPA, FAAP, FACP, FAHA, FTOS, Obesity Medicine Physician Scientist, Massachusetts General Hospital and Harvard Medical School

Host:

  • Tamara A. Baker, PhD, FGSA, Professor, Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill

Support for this podcast was provided by Novo Nordisk. The content was developed by The Gerontological Society of America.

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