Do you find it difficult to lose weight? You are not alone. Many people experience that losing weight becomes even more challenging with age. Is weight loss more challenging as we get older? In this post you will learn how to effectively reduce weight and what things in particular you should focus on if you have passed 50.
It is a widespread opinion that as we age weight loss gets more difficult. With age there is a tendency to add weight, and many come to a point where weight loss is desired. The combination of gradually increased fat mass and age-related muscle loss (sarcopenia) may with age influence functional level, health and quality of life.
There are several reasons why it is a tendency to develop overweight and obesity as we age.
- Reduced physical activity level
- Diseases that limit the possibility for physical activity
- Mental factors such as depression and stress
- Certain medications (eg. prednisolone, antidepressants, certain pain medications)
- Lower resting metabolism due to age-related muscle wasting
- Women: Lower estrogen levels after menopause
Sarcopenia – age related muscle loss
It is common to lose muscle mass as we get older. People over 50 years of age lose yearly about 1-2% muscle mass (1)
Weight reduction, that often leads to reduced muscle mass becomes an even bigger challenge among the elderly who wants to lose weight, as they often lose additional muscle mass. This can increase the risk for fractures, reduced mobility and loss of independence and autonomy.
Elderly people need more protein
What can you do to maintain muscle mass if you are 50 and beyond and want to reduce weight? Maybe an increased intake of proteins in the diet can prevent further loss of muscle mass during a weight loss phase?
There is research that suggests that recommended daily intake of proteins of 0.8g/kg/day is insufficient to maintain muscle mass among elderly people (2). People above 65 years of age are thus recommended to eat 1.1 – 1.3 g/kg body weight per day of proteins (3). This may reduce the risk for developing sarcopenia (age-related muscle wasting).
Protein rich foods include both plant based foods and animal based foods. The protein quality is in general higher form animal sources while the general health effects seem to be favorable for plant sources.
Animal sources
- Fish
- Low fat dairy products such as milk, cheese and yoghurt
- Egg
- Meat, both red and white
Plant based sources
- Legumes
- Seeds and nuts
- Tofu
- Whole grains
- Quinoa
Strength training and proteins preserve muscle mass
Many elderly people do only walking as exercise. In order to reduce age related muscle wasting resistance training is a better alternative. In a study over 1.5 years 250 overweight participants in their 60s participated in a weight reduction program where they were prescribed either
- Calorie restriction and resistance training, or
- Calorie restriction and walking
The participants that did resistance training lost LESS muscle mass (1kg vs 2kg) and lost MORE body fat. The scientists observed that walking and dietary changes caused more loss of muscle mass compared to dietary changes alone (4).
The combination of resistance exercise and increased protein intake is thus particularly useful for preserving muscle mass during weight loss.
It is not more difficult for the elderly to lose weight
The same lifestyle changes that can help young people to lose weight are also effective tools for older people. In a study of 240 participants, the researchers compared the effect of a weight reduction program on people under 60 with people over 60. The lifestyle interventions included advice and guidance on physical activity, dietary changes and psychological support. During the study both groups had about the same weight loss. In fact, people over 60 lost somewhat more weight than those under 60 (5).
Nevertheless, it can be challenging to succeed with weight reduction, and many people find that they have to put a lot of effort into it to achieve sustaining weight loss. One of the reasons for this is metabolic adaptation – lowering of the resting metabolism. This is a response to weight loss. Studies have shown that this effect occurs when the weight has been reduced with 10-20%. However, when the weight loss stops, the resting metabolism returns back to normal.
The fact that people gain weight again after weight reduction is often due to an increased activity of the hedonistic system. The reward system of the brain is turned up when there is a significant weight loss. We eat for many different reasons, one of which is for pleasure. When the reward system is turned up by a major weight loss, it becomes a greater challenge to maintain a reduced calorie intake (6).
There is documentation that suggests that resting metabolism begins to decrease from around 45 years of age, and total energy turnover from around 60 years of age (7, 8)
For older people, it may be more appropriate to avoid too rapid weight reduction due to increased loss of muscle mass with rapid weight loss. Try to lose about 0.5kg a week, and make sure you eat nutritious food. It can make it easier to preserve muscle mass in the process.
Practical tips for weight reduction
Should I focus most on dietary changes or increasing physical activity to reach my weight loss goal? For most people dietary changes are more important than physical activity to achieve weight reduction. This is because most people find it is easier to eat fewer calories than to burn the same amount of calories through physical activity. A regular meal can often contain 500-700 kcal. This corresponds to approximately one hour of jogging, which for most people is more demanding than eating a correspondingly lower amount of calories.
Dietary strategies for weight loss
1) Counting calories
Calorie counting is a “waterproof” weight loss strategy where you keep track of how many calories you eat during the day. The starting point is how many calories you need to maintain your weight and usually deduct about 500 kcal. If, for example, you need 2000 kcal to maintain your weight (based on activity level, weight, etc.) a daily intake of 1500 kcal will result in a weight loss over time, approx. 0.5 kg per week.
Advantages: There are no restrictions on which foods you can eat. This means that you can eat the same diet as before.
Challenges: It is difficult to get an overview of how many calories you actually eat during a day. However, there are tools that can contribute to success with this strategy, e.g. a food table and a digital diet planner.
2) Changing the food
Another well-documented strategy is to change the diet to a type of diet that has been shown to reduce weight over time, without you having to focus too much on how many calories you eat. There are several dietary patterns that you can choose from in order to find a diet that fits your taste:
Carbohydrate-reduced diet / low-carb diet
In this strategy, the intake of carbohydrates is reduced and most of the calories come from proteins and fats. It is recommended to choose plant-based proteins where possible to avoid intake of animal foods above the recommended level. This type of dietary pattern has been shown to reduce weight somewhat more than other dietary patterns in the first months, partly because this diet also causes some loss of fluid/water.
Low-fat diet
In this diet, the intake of fat is reduced, i.e. you limit / avoid fatty foods such as butter, cream and other fatty animal foods, as well as oils and fatty plant-based foods such as e.g. nuts and seeds.
Whole food plant based diet
The biggest weight reduction observed with a diet plan that has no restrictions on how much food you can eat, is a low fat version of the whole food plant based diet (9). With this strategy you can eat as much food as you want, without thinking about the number of calories. However, there is a restriction on which foods you eat. A plant-based diet means that you only eat 1) plant-based foods, and 2) food that has not been processed to a significant degree. This means that you avoid refined grains, soft drinks and other refined plant-based foods. Some will find the diet restrictive.
Many people may be unfamiliar with how to cook totally plant based. If you are interested in testing this heart- and weight loss friendly way of eating I have attached a link to a Vegan Based Electronic Cookbook with 300 dishes.
Following the national dietary guidelines
Use public dietary guidelines as a background diet and focus on low-calorie and fiber-rich foods. A simple strategy is to ensure that you get a minimum of 500g of fruits and vegetables every day, and reduce “calorie bombs” such as sweets and fatty foods. Choose water as a thirst quencher.
3) Time restricted eating, 5:2 diet, intermittent fasting
A third and somewhat less researched dietary strategy (10) involves eating within a period of 6-8 hours during the day, for example between 08 – 14/16, or eating just a little (500kcal) two days a week. Advantages: You can eat the foods you are used to and like, and lose weight at the same time. Disadvantages: Especially at the beginning of such a program, you may experience a feeling of hunger outside of the eating period. However, the body has an ability to adapt to this.
Important behavioral and cognitive factors for weight reduction
Motivation
If motivation to lose weight is high, you are more likely to reach your weight loss goal, compared to if motivation is low. In general, the greater the weight-related problems are, the higher the motivation is to lose weight. However, it is best to reduce the weight before developing weight-related problems. If the motivation is lower than 7 on a scale from 1-10 it may be useful to work on building motivation, on your own or together with a healthcare provider.
One thing at a time
At the rehabilitation center where I work, it is not uncommon for patients to return home with the goal of quitting smoking, exercising more, lose weight and perhaps also changing their diet. This is not recommended, as humans are not wired to work effectively with many large lifestyle change processes simultaneously. Feel free to start with what you are most motivated to change. When you are well on your way and feel that the changes “go by themselves”, you can continue with other lifestyle changes.
Goals and milestones
Losing weight is often a long-term project. Maybe there are several years to the finish line. To avoid getting bored and lose motivation before you reach your goal, it is important that you not only set yourself a main goal, but also set sub-goals along the way. It is recommended to set goals that are not too far in the distant. Try to set goals that you may reach in maximum of 2-3 months. In that way, motivation is preserved.
Keep track of the weight and other measures
Even if you are “unfamiliar” with the bathroom scale, you are more likely to reach your weight goal if you weigh yourself 1-2 times a week. In addition to keeping an eye on the weight, it is important that you also keep track of the implementation of dietary measures.
Social support
While some people are quite independent and succeed in weight reduction on their own, there are many who find that support from family, friends or healthcare personnel is important to succeed in weight reduction. In addition, telling others that you have decided to lose weight will help to strengthen your own motivation and ability to carry it out.
One step back does not set you back to start
A process of change rarely goes in a straight line from A to B. It is expected that you will experience mistakes and setbacks when you change your lifestyle. It is therefore important that you are aware of this, and do not lose heart when the weight not always heads downward, or that you succumb to food temptations. The faster you can put the mistakes behind you, without punishing yourself, the greater is the probability of reaching the weight goal that you have set.
Be prepared
If many of the meals are eaten outside the home, for example at restaurants, it can be useful to think through what you want to eat, before you sit down with a tempting menu. It is often more challenging to choose the “right” food to eat when you have all the tempting options in front of you, compared to planning in advance what type of dish you want to eat when you get to the restaurant.
Does physical activity contribute to weight reduction?
For weight reduction, physical activity is primarily important for maintaining weight loss, but feel free to combine dietary changes with physical activity. For people over 50-60 years of age, it is important to include strength training to prevent weight loss related and age related muscle loss. Aim for 30 to 60 minutes of phyiscal activity with intensity similar to brisk walking.
Conclusion
Research shows that it is not more difficult for elderly people to lose weight compared to younger people. Weight reduction requires motivation and effective strategies regarding diet and physical activity. However, some of the recommendations for weight loss are even more important for elderly people than younger people, such as the importance of resistance training and adequate protein intake.
- Set realistic goals. Don’t try to go down too much too fast. A healthy weight loss is 0.5-1 kg per week.
- Find a diet strategy that you can follow over time. There are many different diet plans and methods, so experiment until you find something that works for you.
- Be active. Physical activity is important for maintaining muscle mass and burning.
- Get support from others. It can be motivating to have someone to share the journey with.
Here are some concrete tips of particular interest to people 50 or beyond, to preserve muscle mass during weight loss:
- Include resistance training. Strength training is the best way to stimulate muscle growth.
- Increase your protein intake. For the elderly, increasing the protein intake to 1.0-1.3 grams of protein per kilogram of body weight per day will likely reduce muscle loss during a weight reduction period.
