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Setting safe weight loss goals for optimal health

While shedding unwanted pounds is hard at any age, it can be especially challenging for seniors.

Unfortunately, too much excess weight can lead to a number of health issues, including heart disease and stroke, type 2 diabetes, arthritis and others. These problems take a huge toll on the nation’s health; statistics show that more than 70 percent of U.S. adults over age 65 currently are overweight or obese.

Seniors looking to lose weight should focus on slow and steady progress toward long-term health rather than just numbers on the scale.

However, losing weight and keeping it off can be done safely and successfully at older ages. The key is setting sensible goals and working toward them slowly and steadily, according to Lindsay Johnson, R.D., L.D., a clinical dietitian with Barnes-Jewish Extended Care, which is managed by Bethesda Health Group. Johnson conducts initial assessments and develops specialized nutrition plans for patients at the 125 facilities throughout the Barnes-Jewish HealthCare network.

She said weight loss success for seniors depends on motivation, healthy food choices and portion control, and “finding joy” in the foods they eat. And there’s no better motivator than wanting to be around for their loved ones in the future. “One year their doctor may say ‘I’d like you to lose 10 pounds’ and they may be thinking about it, but the next year if the doctor says ‘Your A1C is elevated and if it continues you could start to lose vision or sensation,’ that’s a different story,” she explained.

“A liberalized diet approach”

Defining a healthy weight is different for older adults than younger ones, Johnson said. Some extra pounds are often desirable to “cushion” the joints due to the possibility of falls and other injuries.  “If you have a female who’s 5-foot-4 and 90 pounds, if she takes a fall there’s a higher risk of hip fracture and less chance that she will rebound. So we do want them to have a BMI at the higher range of normal,” she explained.

Johnson recommends the MyPlate method for almost all of her patients because it can accommodate all types of individual preferences. The easy-to-follow plan, available online at myplate.gov, calls for one-fourth of the plate at every meal to be a carbohydrate [bread, rice, pasta]; one-fourth to be a protein source [chicken, fish, beef, beans, tofu] and the remaining half to be fruits and vegetables.

“It’s a liberalized diet approach. When you put people on a less restrictive diet, they are able to manage their weight more successfully,” she said.

A safe weight loss plan means cutting no more than 500-750 calories a day, which generally leads to about a pound per week of weight loss over time. “Any more than that and your base metabolic rate will decrease,” she added.

When following the MyPlate plan, a number of helpful apps such as LoseIt can help seniors calculate their daily calorie intake – if you see weight loss when you step on the scale, you know you’re on the right track, Johnson said. It’s also a good idea to include some heart-healthy fats on your plate; fat is necessary for good health, and you’re more likely to feel deprived and overeat later if you avoid it.

Hit the gym sensibly

For seniors and younger adults alike, the most successful diet plans include a combination of exercise and calorie reduction. If you’re not exercising and on your feet being active, you have to reduce portions even more to lose weight, Johnson pointed out.

Clinical Dietitian Lindsay Johnson counsels a client. [Bethesda Health Group photo]

Calorie needs are related to lean body mass; a pound of muscle needs more calories to maintain than a pound of fat.

“Three days a week of light weight training really can give you an edge – if you’re doing this you can get away with an extra 150-500 calories each day without it showing up on your waistline,” she explained. For example, a female who goes to the gym three times a week and is also fairly active might need 1800 calories a day to maintain her weight instead of 1300, so losing weight is easier.

“Also, in general we like to encourage more protein, especially for seniors who are working out. This can be gotten through snacks like yogurt, a handful of nuts, peanut butter, or a hard-boiled egg on days that they’re exercising,” she added. The MyPlate plan calls for a protein portion about the size of the palm of your hand [4-6 ounces] for lunch and dinner every day, except for those with kidney disease, whose protein intake should be lower to protect their kidneys.

For seniors who don’t exercise but would like to start, a visit to the doctor first is essential to get medical clearance; after that, a certified personal trainer can do an assessment of their current exercise tolerance and help them build a safe routine.

Overall, the journey to successful weight loss after midlife may be slow and include a few detours – but that’s OK, Johnson emphasized. “Seniors tend to have a lot of family get-togethers that center on food, and they also tend to be the cooks … Sharing love often means sharing food,” she said. But it’s possible to do this using the MyPlate method, indulging in those favorite foods in moderation.

And sometimes it’s fine to just enjoy the moment and have those extra treats. This can be balanced out through physical activity like taking a walk around the neighborhood with family and friends afterward, she added.

Because most seniors are on medications and may have co-existing conditions like heart disease or hypertension, Johnson said a doctor’s approval is necessary before starting any diet or exercise plan. Working with a professional dietitian can also make weight loss a safer, more successful process – in addition to helping with an eating plan, dietitians can analyze current lab results and monitor health conditions like prediabetes to help them manage blood sugar levels and optimize health.

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