New recommendation for people over 70 in updated obesity guidelines

A year ago, the National Board of Health and Care published the National Obesity Care Guidelines for the first time. Now they have updatedfollowing opinions from the healthcare system.

The biggest change is the addition of a special joint lifestyle recommendation for older adults with obesity, according to Elva Troll Lagerus, senior physician in the Obesity Center at the Academic Center Specialist in Stockholm, who was involved in the work on the guidelines.

– It’s an important recommendation. There are many active and energetic people over the age of 70 who also want to lose weight, and the question is how should the healthcare system deal with it?

Action gets priority number 6, and it’s lower than other adults, which get priority number 4.

– Because there are greater risks with losing weight when you are older, you should think carefully about whether to subject an elderly person to intensive weight-loss therapy. For the vast majority, the answer is “no,” says Elva Troll Lagueros.

She stresses that it is still important to have a healthy diet, physical activity, and balance training in older people, but one should not strive for the same drastic weight loss as in younger people.

The clinical benefit of losing weight dramatically is much greater if you are 22 than if you are 72. If you are 72 years old, you will lose much more muscle mass while losing weight than if you were 22 years old. We also know that for many elderly people it can be a good idea to gain a few extra pounds if you get sick.

Another piece of news is surgery for people with a BMI between 30 and 35.

Ylva Trolle Lagerros has stated that for a long time, the maximum time that surgery might become relevant was a BMI of at least 35. This is something that is starting to fade.

But where in the previous version of the guidelines it was simply stated that surgery was recommended from a BMI of 30, it is now clear that it is reserved for patients with serious obesity-related diseases – for example type 2 diabetes, sleep apnea syndrome or Severely restricted movement.

– The previous version was not clear here. By clarifying and ensuring that this information is included, we are moving at a consistent pace with international guidelines that came recently after not being updated since 1991, says Ylva Trolle Lagerros.

Another change is that sleeve gastrectomy surgery is now given a priority number – although it is lower than that of gastric bypass surgery – rather than being categorized as research and education when it comes to the use of, for example, young people between the ages of 15 and 17 years old.

– When the guidelines were issued, there wasn’t enough scientific support to make a recommendation about sleeves for young people, for example, but there is now, says Ylva Trolle Lagerros.

Lakartidningen.se 2023-05-09