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What Your Weight in Your 60s Says About Your Health

Find out what the extra pounds really mean to our mental and physical health, and six effective weight-loss strategies to take in this crucial decade of your life.


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ILLUSTRATIONS BY CHRISTINE RÖSCH

When it comes to weight, your 60s are a pivotal decade.

A full 41.5 percent of adults age 60 and older are considered obese, according to data from the Centers for Disease Control and Prevention. With age, your body accumulates more fat and deposits more of it around your middle, while at the same time you’re losing muscle, all of which introduces higher odds for developing a cadre of health problems — high blood pressure and cholesterol, type 2 diabetes, sleep apnea and a decline in physical functioning.

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Your weight isn’t everything, but it can indicate how much body fat you’re carrying. And body fat isn’t just benign, sleepy stuff; it acts as an endocrine organ that’s involved in the metabolism of sex hormones, blood clotting and blood pressure, and insulin sensitivity.

Hitting that sweet spot — not too much, not too little — is important for aging well. Doctors use the BMI scale (body mass index) as one measure of body fat to determine whether you’re underweight, healthy weight, overweight or obese. (Find yours at aarp.org/bmi.) In the general population, a BMI of less than 18.5 is considered underweight; 18.5 to 24.9 is healthy weight; 25 to 29.9 is overweight; and 30 and over is obese, with a BMI of 40 or higher indicating severe obesity.

But those numbers might not apply so clearly to people in their 60s. One 2022 study found that the best BMI for health for those over age 65 is 27 to 28 in men and 31 to 32 for women. This is referred to as the obesity paradox, and exactly why it exists isn’t fully understood, says Kristen DeCarlo, M.D., a geriatrician who practices in the areas of endocrinology, diabetes and metabolism at UI Health in Chicago.

That doesn’t mean you should ignore weight gain. Consider your weight one indicator of your health, along with your blood pressure, blood sugar and cholesterol levels. But pay attention to where you’re carrying those pounds too.

“Visceral fat is the fat that’s hidden in your abdominal cavity,” says Jean-Pierre Després, a professor in the department of kinesiology at Université Laval in Quebec City, Quebec. More visceral fat means more than just a wider waistline; it means a higher risk for heart disease, diabetes and stroke.

What’s happening to my body in my 60s?

“Our bodies are different in our 60s from when we were in our 20s and 30s,” says Gitanjali Srivastava, M.D., medical director of Vanderbilt Obesity Medicine at Vanderbilt University in Nashville.

1. You may still be gaining fat

The fat gain you experienced in your 50s may continue into your 60s. “For reasonably healthy adults, there’s a natural increase in body fat until your 80s,” says DeCarlo. Hormonal changes and medication side effects, coupled with muscle loss and fat gain, add up to a body that now carries around proportionally more fat.

2. Your muscles need protection

It’s generally believed that every pound lost through diet is about 75 percent fat and 25 percent muscle, says DeCarlo. If your doctor has advised you to lose weight, the key is to hold on to as much muscle as you can. Do that by consuming 15 to 25 percent of your daily calories from protein and regularly participating in both aerobic exercise (150 minutes a week of walking, biking, jogging or swimming) and resistance exercise (weight lifting at least twice a week). You may lose as much as 3 percent of your overall muscle strength every year in your 60s. Men tend to hold on to more of their muscle power longer; for women, the decline happens quickly after age 65.

3. Your metabolism is on the fritz

This is the decade when metabolism is starting to sputter. Your metabolism — or the rate your body burns calories — remains pretty stable in your adult years until your 60s. A 2021 study in Science identified “the break point”: age 63, after which metabolism begins to decline. Your body requires fewer calories to keep it working (your heart beating, your lungs breathing); having less muscle also contributes to a more sluggish engine.

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4. Your waistline doesn’t lie

There’s a cheap and easy way to get an idea of how much of the concerning visceral fat (as opposed to subcutaneous fat — more on this shortly) is setting up shop in your belly: Measure your waistline. Men should be under 40 inches; women should be less than 35 inches. Also, check your pants. The butt may be baggier but the waist tighter. “How your pants fit can be an accurate indicator of visceral fat,” says Srivastava.

5. Menopause has left a mark

By the time a woman is postmenopausal, 15 to 20 percent of her body fat is visceral fat, compared with just 5 to 8 percent when she was premenopausal. These changes are associated with higher blood pressure, cholesterol, insulin resistance and inflammation, according to a 2022 review at Columbia University.

6. Your neck may be getting thicker

Are the collars on your button-ups too tight? It’s not the dry cleaner’s doing. As we age, our muscles loosen and become laxer, and “there can be more fat deposition in areas near the base of the tongue,” says Srivastava. A neck size greater than 16 inches for women or 17 for men, she says, can be a sign that you’re carrying excess fat in the neck, which can put you at risk for conditions like sleep apnea.

Why visceral fat is bad for you

As you age, the fat underneath your skin begins to reroute into your abdomen, where it becomes visceral fat, says Srivastava. Visceral fat is the deeper fat that lives within your belly and hugs your stomach, liver and intestines. Your butt, legs, arms and face may appear thinner, but more visceral fat equals a wider waistline, and that distribution matters: “Visceral fat is the more dangerous fat to have,” she says. When Austrian scientists scanned the bellies of 10,894 people for a 2020 study, they found that 20-year-olds had on average less than a pound of visceral fat. It surged to over 2 pounds for women and 4 pounds for men by their 60s.

While many of us monitor our weight out of vanity, doctors suggest you consider monitoring your weight, BMI and waist measurement as important as monitoring your blood pressure, blood sugar and cholesterol levels. If they get out of control, you may be in danger. When scientists tracked 190,672 adults for 10 years or longer, obesity boosted the risk for heart attacks, strokes and heart failure — and nearly tripled the odds for the most obese middle-aged group.

Even those without obesity can be at increased risk from visceral fat, says Morgana Mongraw-Chaffin, assistant professor of epidemiology and prevention at the Wake Forest University School of Medicine in Winston-Salem, North Carolina. She conducted a study of 1,005 midlife women and men, none of whom had obesity. But those with higher levels of abdominal fat raised their risk for diabetes by 51 percent and doubled their risk for metabolic syndrome — a collection of risk factors including low levels of heart-helping HDL cholesterol, high levels of ticker-menacing triglycerides, and above-normal blood pressure and/or blood sugar.

The good thing about visceral fat is that you can lose it quickly. One study found that just four weeks of brisk walking resulted in an inch reduction in waist circumference. “With exercise, you can lose visceral fat even if you don’t lose weight” says Després. Reducing your waist size by about 1.5 inches can reduce the risk for diabetes by 60 percent.

Weight, cancer and immunity

There’s another common killer that becomes more prevalent as we reach our 60s: cancer. Rates increase from about 350 cases per 100,000 people in those ages 45 to 49 to more than 1,000 per 100,000 people in those 60 and older. One reason, according to the National Institutes of Health, is the decline in the immune system’s ability to detect and correct cell defects.

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According to the Centers for Disease Control and Prevention, obesity is linked to at least 13 types of cancer. Some are hormone-related: Obesity creates inflammation, which disrupts the immune system, and causes dysregulation of the hormonal system. “Obesity leads to an increase in certain hormones that lead to an increase in cancer: breast, endometrial, thyroid, pancreas and so forth,” says Omar Ghanem, M.D., a metabolic surgeon at the Mayo Clinic in Rochester, Minnesota. “Those connections are well established, and we know that losing weight with bariatric surgery can reduce the risk,” he says.

Bariatric surgery has been shown to reduce cancers that aren’t related to hormone levels. In a recent analysis of 15 studies, including a total of nearly 950,000 people with obesity who underwent bariatric surgery and more than 17 million who didn’t, the researchers found that the surgery group had an almost 50 percent reduction in the risk of liver, colorectal, kidney, urinary tract, esophageal and lung cancers.

Obesity is also a risk factor for developing an autoimmune disease, a problem that becomes more common with age, particularly in women. These diverse conditions, including lupus and rheumatoid arthritis, occur when the immune system starts attacking the body’s own healthy tissues. “People with rheumatoid arthritis in particular have premature immune aging,” says Cornelia Weyand, M.D., an immune system researcher at the Mayo Clinic in Rochester, Minnesota. “Their immune age is about 25 years older than their actual age.”

The last three years have driven home how obesity can impact the immune system. Researchers recently looked at how weight affected outcomes for some 150,000 COVID patients. They learned that patients with a BMI of 30 to 34.9 (just above the “obesity” threshold) were 7 percent more likely to be hospitalized and 8 percent more likely to die than people who were a healthy weight. Those with a BMI of 45 or higher (considered “morbidly” obese) were 33 percent more likely to be hospitalized and 61 percent more likely to die.

But the immune system can rebound if you bring your weight under control. A 2022 study at Brigham and Women’s Hospital of people with obesity who lost 18 percent of their body weight after weight-loss surgery revealed that within just three months, the patients’ immune systems were measurably healthier, with reduced white blood cell levels and reduced inflammation.

How we think about weight

Conventional wisdom once said that “feeling fat” was strictly a young person’s problem. Now a wave of research is uncovering long-overlooked struggles — and newfound wisdom — about weight and body image for people in their 60s. “It’s not like you grow out of a negative body image,” says psychologist and body image researcher Lisa Kilpela, an assistant professor at the University of Texas Health Science Center at San Antonio. “There are a lot of reasons to suspect it could get worse with age for some people.”

"It’s not like you grow out of a negative body image. There are a lot of reasons to suspect it could get worse with age for some people."

Lisa Kilpela, psychologist and body image researcher

Over half of women in their 60s say weight or body shape concerns have a negative impact on their lives. In one large University of North Carolina at Chapel Hill survey, up to 64 percent thought about their weight every day. Men aren’t exempt. Half in a small Canadian study of men ages 60 to 83 said they felt unattractive because of their weight.

Body dissatisfaction made 17 percent of men and 39 percent of women ages 50 to 65 uncomfortable wearing a bathing suit in public, according to a UCLA survey of over 52,000 U.S. adults. But in your 60s, a negative body image can have far more serious consequences: Binge-eating was a problem for up to 26 percent of women ages 55 to 83 in a recent study by Kilpela and others. “For the longest time, people didn’t think older women had eating disorders,” Kilpela says. “Older women who come to our lab say things like, ‘Thank you for thinking of us. We thought we’d be the forgotten ones because of our age.’ ”

Body dissatisfaction is associated with higher risk of depression, poorer sleep and less than optimal self-care. “It’s like the way you treat an old pair of sneakers versus a brand-new pair,” says Kilpela.

Of course, not everyone in their 60s battles big-time body dissatisfaction, says psychiatrist Debra Safer, M.D., an associate professor of psychiatry and behavioral sciences at Stanford University who specializes in treating eating and weight disorders. In a study of body image and “fat talk” in women ages 18 to 87, just 12 percent of those 61 and older said they harangued themselves frequently about their weight — the lowest number of any age category in the study.

“Self-compassion is the antidote,” Safer says. “Compassion for all your body has allowed you to do and still enables you to do.”

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CHRISTINE RÖSCH

6 Most Effective Weight-Loss Steps to Take in Your 60s

Eat less, move more. Losing weight comes down to just those four words, right? Not really. Decades of research show that effective weight loss involves food choices as much as, if not more than, food volume. And certain lifestyle choices significantly affect success or failure. These six steps are widely accepted as key to effective weight loss.

1. Start your day with protein

Studies show that “protein timing”— eating 25 to 30 grams of protein in the morning, and the same amount at lunch and dinner—helps people at midlife and beyond maintain muscle mass, which in turn reduces fat gain. This is the basis of AARP’s New York Times bestseller The Whole Body Reset. The average American currently eats about 10 grams at breakfast and about 60 grams at dinner.

2. Choose farm foods over factory foods

That means fruits, vegetables, nuts, seeds, seafood, olive and avocado oils, low-fat dairy and lean meat throughout the day. The fewer processed foods, the better. Foods in their natural form are the basis of the Mediterranean and DASH diets, which are consistently rated as the best programs for weight management, heart health and longevity.

3. Move at least 30 minutes a day

Daily active living beats a few weekly gym sessions and sitting around the rest of the time. Aim for a total of at least 150 minutes of movement per week — walking swimming, biking, gardening — for cardiovascular fitness, and at least two days a week of resistance training for muscular strength, as recommended by the Centers for Disease Control and Prevention.

4. Cut down on simple carbohydrates, especially sugar

That means minimizing cookies, sodas and other sweets. Simple carbs not only fill you up with calories while providing minimal nutrition, but a higher carbohydrate intake leads to water retention, making you look, feel and weigh heavier.

5. Stop eating at 7 p.m.

Eating later in the evening increases your next-day hunger, decreases your next-day calorie burn and triggers your body to store more fat, according to a recent study.

6. Go to bed at least seven hours before you need to wake up

Ghrelin is the hormone created in the stomach that signals us to eat. Sleeping less than seven hours a night has been shown to elevate ghrelin, meaning you may be driven to consume more calories the next day.

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