Consenso de expertos en prevención, diagnóstico y tratamiento de la obesidad en el adulto mayor y en casos especiales

The prevalence of obesity is increasing in all age groups, including the group of people over 65 years. However, appropriate clinical approach to obesity in the elderly is controversial due to the reduction in relative health risk associated with increased body mass index, the variable efficacy of drug treatment and the effects of weight loss on muscle mass and bone tissue. The purpose of this consensus, in which 20 specialists participated within the field of Geriatrics, Internal Medicine, Endocrinology, Cardiology, Psychiatry and Nutrition, was to review the clinical aspects of obesity in the elderly to provide health professionals control weight guidelines appropriate for this population. Each participant established the evidence and recommendations on the various issues addressed by greater clinical experience, being enriched by the opinions of other experts. At the end, all the evidence without a CPG reference was rated according the National Institute for Health and Clinical Excellence (NICE), and the decisions taken were unified in the document presented here. The consequences of obesity on the health of the elderly are related to the decrease in peripheral lean mass, increased visceral fat and fat deposition in muscle, liver and pancreas. Obesity is associated with morbidities such as diabetes, hypertension, dyslipidemia, metabolic syndrome, cancer, arthritis, asthma and poor physical health, among others. The relative risk of mortality and decrease in survival are altered after 60 years and the absolute risk of mortality increases with body mass index after 65 years. ©2016 Medicina Interna de México, Comunicaciones Científicas Mexicanas S.A. de C.V.