*Based on an article in AARP magazine by Jessica Migala; professional and medical sources listed at the end of this post.)

If you’re anything like me, you have been conscious of your weight most of your life, and your relationship with the scale—any scale—has not been a happy one. I was a chubby pre-teenager who tried everything to lose weight, all to no avail. Even my grammar school graduation picture had to be slimmed down before it was deemed acceptable. I thought I was doomed to a lifetime of being not-so-pleasingly plump, but a miracle occurred when I turned fifteen: I grew two inches and lost thirteen pounds. Thin was definitely in back then, and it was what I longed to be.

Yearning to look like Twiggy (a very thin sixties icon) at the age I am now would be a very bad idea. As we age, we have to change our attitudes about many things, but our weight should be at the top of that list. We shouldn’t envy runway models, who tend to look as if they’re starving. If we’re smart, we will also avoid the other extreme—obesity—which increases our chances of high blood pressure, diabetes, heart disease, sleep apnea, joint problems, and cancer. Excess weight puts a strain on your heart and increases the risk of heart failure and arterial fibrillation. Three out of four people in their seventies and even more in their eighties have some degree of cardiovascular disease, and older adults account for 80 percent of heart disease deaths. Obesity is the silent killer of the immune system, which becomes more sluggish as we age, and has been linked to at least thirteen types of cancer. When obesity comes with lots of visceral fat, it is a risk factor for faster brain aging and Alzheimer’s disease.

But staying in a healthy zone requires a bit of a balancing act. While you don’t want to pack on the pounds, shedding them quickly isn’t always a good idea either. Losing weight unintentionally may signal that you are also losing muscle mass. After years of yo-yo dieting, you may wonder how you could now be at risk of “losing weight unintentionally.” Sudden weight loss may be due to depression, anxiety, medications, or even some cancers. It is generally believed that every pound lost is about 75 percent fat and 25 percent muscle. By the time you reach your eighth or ninth decade, half of your muscle mass may have vanished. Paying attention to changes in your weight and body shape, as well as trying to hold on to as much muscle as possible, can help you stay in a healthy range in your later years.

Since your sixties, your metabolism – the rate your body burns calories—has been slowing down. Your body requires fewer calories to keep your heart beating and your lungs breathing. In your nineties, you may burn only 75 percent as many calories as your middle age cells. Your immune system gradually declines from your forties into your seventies and then begins a precipitous drop in your eighties leading to a decline in the production of the active antibodies that can neutralize viruses. Aging also increases systemic inflammation, which may be driven by increased fat. The more fat you have, the more inflammation. Inflammation disrupts the immune system as well as your hormonal system.

As we reach age seventy-plus, many of us are finding freedom at last from old body shame stigmas and can finally relax. Unfortunately, eating disorders remain an issue for older people. Binge eating is a problem for up to 26 percent of women aged sixty to eighty-three. At any age, disordered eating has a negative effect on your mental health. If you struggle with body dissatisfaction, paired with weight stigma, you have a higher risk for depression. A 2021 study found that women with negative body image got poor sleep and had less social support. A negative body image is also associated with eating a less healthy diet and getting less physical activity. Our diet culture caters to young people; so, it may take a little effort to find out about the positives and negatives of weight loss and weight gain after seventy and what to do about it.

All of that may be more than you wanted to know about your weight, then and now, but I think it’s important for older adults to face the fact that everything changes when it comes to weighing in. Life was very different in the fifties when I was in high school. The rules of style have changed every decade since then, and so have I. Fitting in, being thin, and looking good in pencil skirts and saddle shoes mattered so much then. Being independent, healthy, relevant, and engaged in life matters more now. In recent years, thin has been replaced by fit, and that is what I aim to be in the years ahead.

What to do about all of that

• If you want to keep good muscle strength as you get older, physical activity and fitness are even more important than weight.
• Resistance training, especially exercises aimed at the larger muscle groups in the body, such as your butt and thighs, is a good place to focus first.
• For healthy weight steps to take immediately:
  • Start your day with protein.
  • Choose farm foods over factory foods—the fewer processed foods the better.
  • Move at least thirty minutes every day—gradually increase the amount of time.
  • Cut down on simple carbs, especially sugar.
  • Join the Y or a health club and start taking classes.

Sources: 

• David Bartlett, adjunct assistant professor of medicine at Duke University
• Jean-Pierre Després, a professor at Université Laval in Quebec City, Quebec, and a leading body, fat, and health researcher
• Kristen DeCarlo, MD, a geriatrician, who practices in the area of endocrinology, diabetes, and metabolism, at UI Health in Chicago
• Howard Fillit, MD, co-founder and chief science officer at the Alzheimer’s Drug Discovery Foundation
• Laura Haynes, a professor of immunology at the UConn Center on Aging in Farmington, Connecticut
• Lisa Kilpela, assistant professor at the University of Texas, Health Science Center at San Antonio
• Carl J. Lavie, MD, medical director of cardiac rehabilitation and prevention at the John 0chsner Heart and Vascular Institute in New Orleans
• Jessica Migala, freelance journalist, specializing in health-related topics and the author of “The Weight Issue” in AARP Magazine
• Ian J. Neeland, MD, coordinator of the Center for Integrated and Novel Approaches in Vascular-Metabolic Disease at University Hospitals, Cleveland Medical Center
• Debra Safer, psychiatrist and co-director of the Stanford Adult Eating and Weight Disorders Program at Stanford University in California
• Gitanjali Srivastava, MD, medical director of Vanderbilt Obesity Medicine at Vanderbilt University, Medical Center in Nashville.