What Your Weight in Your 70s (and Beyond) Means for Your Health

It’s generally believed that every pound lost is about 75 percent fat and 25 percent muscle, DeCarlo says. That’s why, rather than losing weight, “preventing weight gain should be the goal,” says cardiologist Carl J. Lavie, M.D., medical director of cardiac rehabilitation and prevention at the John Ochsner Heart and Vascular Institute in New Orleans. “There are some risks with losing weight, especially in elderly people, in their upper 70s and 80s. You want to keep good muscle strength as you get older. Physical activity and fitness are even more important than weight now.”

“We see a lot of octogenarians who have obesity, are struggling to lose weight, but are also very frail and have multiple medical problems,” says Srivastava. Having more muscle mass — even if your weight puts you in the obese category — is protective; your doctor can assess you for sarcopenia and then make a recommendation from there.

3. Weight loss can happen unexpectedly

Up to one in five older adults loses weight unintentionally, which is defined as losing 5 percent of one’s body weight within six to 12 months without a known cause (such as dieting, exercise or a medication side effect). This loss may be due to depression, anxiety, medications or even some cancers. No matter what your starting weight, if your clothes are suddenly mysteriously baggy, flag it for your doctor.

4. Your metabolism is slowing

Since your 60s, your metabolism — the rate your body burns calories — has been sputtering. Your body requires fewer calories to keep your heart beating and your lungs breathing; having less muscle — metabolically active tissue that burns more calories than fat — also contributes to a more sluggish engine. In fact, in your 90s, you may burn only 75 percent as many calories as your middle-aged self.

5. Your face and your butt have become thinner

Over the past few decades, some of the fat beneath your skin (subcutaneous fat) relocated to your abdomen, where it became visceral fat, says Srivastava. Visceral fat is the type that lives deep within your belly and hugs your stomach, liver and intestines. As a result, your butt, legs and arms may appear thinner and your face less full. “Patients talk about their skin feeling like paper; they report barely bumping themselves and getting a scrape,” says DeCarlo. Some of this, she explains, is a decrease in collagen and elastin, your skin’s support structures.

Your weight and your risk of chronic disease

Three out of four people in their 70s and even more in their 80s have some degree of cardiovascular disease, and older adults account for 80 percent of heart disease deaths. For many, it’s the result of years of high cholesterol, high blood pressure and/or high blood sugar. For others, it’s new damage, as aging stiffens arteries and heart valves, boosts blood pressure, and weakens your ticker’s ability to pump strong and keep a steady beat. A lifetime of carrying extra weight also takes a toll.

“Excess body weight puts a strain on your heart that increases the risk for heart failure and atrial fibrillation [offbeat heart rhythms that boost stroke risk],” Lavie says.

That said, where you carry the weight may matter more than how much you carry. While some fat under the skin may be protective, visceral fat can be toxic.

“Visceral fat releases fatty molecules into the blood. And it’s invaded with immune cells called macrophages that create low levels of chronic inflammation in the body,” explains Jean-Pierre Després, a professor at Université Laval in Quebec City, Quebec, and a leading body fat and health researcher.

Visceral fat can wrap around your heart and kidneys and infiltrate your liver, boosting risk for diabetes by interfering with your body’s ability to absorb blood sugar, says cardiologist Ian J. Neeland, M.D., codirector of the Center for Integrated and Novel Approaches in Vascular-Metabolic Disease at University Hospitals Cleveland Medical Center. “It’s a big driver for cardiovascular disease.”

Meanwhile, our immune system becomes more sluggish as we age, a problem compounded by excess fat. “Obesity is the silent killer of the immune system,” says David Bartlett, adjunct assistant professor of medicine at Duke University.

Our immune system gradually declines from our 40s into our 70s, and then begins a precipitous drop in our 80s, leading to a decline in the production of effective antibodies that can neutralize viruses, says Laura Haynes, a professor of immunology at the UConn Center on Aging in Farmington, Connecticut. “The other thing that happens with age is an increase in systemic inflammation, which may be driven by increased body fat. The more fat you have, the more inflammation.” Inflammation disrupts the immune system as well as your hormonal system. According to the Centers for Disease Control and Prevention, obesity is linked to at least 13 types of cancer.

A combination of aerobic and strength training is the answer, says Bartlett. “A fair amount of observational data shows that if you’re physically active, you can improve your immune system, even if you start later in life,” he says. “Exercise moves cells around the body and into the blood, including dysfunctional T cells, which end up being cleared out of the body. In older athletes, we see a T cell profile similar to someone who is much younger.”

How we think about weight

As we reach age 70-plus, many of us are finding freedom at last from old body-shame stigmas.

Surveys by University of North Carolina at Chapel Hill researchers found that women in their 70s were the least dissatisfied with their bodies and the least likely to say they thought about their weight every day — or several times a day.

That said, disordered eating remains an issue for older people, says psychologist and body image researcher Lisa Kilpela, an assistant professor at the University of Texas Health Science Center at San Antonio. Binge eating was a problem for up to 26 percent of women ages 60 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.’  ”

While there’s little research on body image in men over age 70, all of the participants in one University of British Columbia study of 28 men ages 65 to 83 said they felt grateful for what their bodies could do. Yet at the same time, most had frustrations about age-related changes, including muscle loss and extra pounds.

At any age, though, your mental health can suffer if you struggle with body dissatisfaction. Paired with weight stigma, body dissatisfaction is associated with a higher risk for depression. In a 2021 study of 181 women ages 50 to 86, Kilpela also found that women with a negative body image got poorer sleep and had less social support. A negative body image is also associated with eating a less-healthy diet and getting less physical activity, says psychiatrist Debra Safer, M.D., the codirector of the Stanford Adult Eating and Weight Disorders Program at Stanford University in California.

Regardless of how you look, or how you feel about how you look, discussing your weight with a health care provider is a smart idea. Our diet culture caters to young people; too few of us know about the positives, and negatives, of weight loss and weight gain after age 70, and what it all means for your unique shape.

CHRISTINE RÖSCH

4 Healthy Weight Steps to Take Today

Maintaining a healthy weight as we age — not too heavy, not too lean — is crucial to maintaining our independence. Here are some simple strategies that will keep you in shape while making sure you get the nutrition you need.

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.

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 having 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.

4. Cut down on simple carbs, especially sugar

Simple carbs like cookies and chips 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.