As growing rates of obesity in children and adults grab headlines, a doctor says another segment of the population is facing the same problem but has been largely overlooked: elderly people, particularly those in retirement communities and assisted care facilities.
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Take three square meals a day (often high calorie, large portion affairs), combine that with little exercise and the dynamic of eating in group settings, and the end result often is weight gain that can affect health and shorten life, said Dr. Carl Wenzel, a Warminster Hospital physician who treats elderly patients.
"We've got a major problem and it's going to get worse" as the U.S. population gets older, Wenzel said. In recent years, he said he has seen a marked increase in older patients with diabetes, high blood pressure, high cholesterol, heart disease and joint problems, ailments often related to weight gain.
The prevalence of obesity among people age 50 and older increased 85 percent from 1982 to 1999, the most recent figures available from the National Center for Health Statistics of the U.S. Centers for Disease Control and Prevention. The rate of obesity falls as age increases, but is still markedly higher in recent years.
For example, the percentage of obese people 85 and older rose from 4.1 percent in 1982 to 8.3 percent in 1999, and the percentage of obese people age 75 to 84 rose from 7.7 percent in 1982 to 15.1 percent in 1999.
Meals in retirement communities and assisted care facilities are often lavish and large, and many elderly people have difficulty burning off those calories because of arthritis and other ailments that slow them down.
Add to that the phenomena in which people tend to eat more in group situations when they're enjoying the camaraderie of others at the table, and you have a recipe for what Wenzel calls the "senior 15" — weight gain of 15 pounds or more in elderly patients.
In an effort to address what he calls a potential epidemic, Wenzel has started visiting retirement homes and assisted care developments to educate residents and staff about portion control and nutrition.
Among the places he's visited are Ann's Choice, a 375-resident retirement community in Bucks County that has retooled its meal plans to provide options that are low in fat and sodium, plentiful in fresh fruits and vegetables and feature heart-smart items like grilled fish and salads.
Diet change difficult for elderly
"We're trying to help people with their diets by having heart-healthy food that people will enjoy," said Mark Diller, Ann's Choice executive chef. "We meet weekly with residents to see what they want and what they don't, and they definitely want healthy options."
That doesn't mean that burgers and mac-and-cheese have been sent packing, however. As long as people opt for those kinds of foods, they'll be available, Diller said.
"One solution is self-restraint, reminding people that they don't need to eat everything that's in front of them," Wenzel said. "We also encourage people to get as much exercise as they're capable of doing, even if it's going to the mall and walking."
Possibly the most difficult lesson to convey to older people, Wenzel said, is diet change.
"We want people to eat less meat and bread and more fruits and vegetables," he said. "But many people of this age group grew up on the traditional meat and potatoes diet. That's how they've always eaten."
Monitoring diet in such large facilities is admirable but there are weightier issues in the battle of the bulge, said Dr. Lesley Carson of the University of Pennsylvania Health System's department of geriatric medicine.
"We really need to address obesity in the young," she said. "With geriatric patients who are obese, often the damage has already been done."
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