Safe & Individualised Weight Management Care in Older Adults

Weight management in older adults is a complex area that requires a very different approach from weight management in younger Australians. Whether in residential aged care or living independently at home, older people have unique nutritional needs that must be supported with care, dignity, and clinical oversight.

Why Restrictive Dieting is Not Appropriate
Restrictive eating patterns - such as low-calorie, low-fat, low-sugar diets, reduced meal portions, or cutting out desserts and snacks are often used by younger people to manage their weight or lower the risk of chronic diseases. However, in older adults, these strategies can do more harm than good, leading to reduced appetite, poor food enjoyment, and an increased risk of malnutrition.

Risks and Benefits of Higher Body Weight
Carrying extra weight in older age can have both challenges and protective effects, which is why a simple focus on weight reduction is not always appropriate.

Risks may include:

• Reduced mobility
• Breathing difficulties
• Higher risk of wound breakdown
• Difficulty fitting into specialised equipment (e.g. wheelchairs)

Benefits can include:

• Increased bone mineral density
• Reduced risk of osteoporosis and fractures from falls

This is why weight alone should never determine health goals. A complete assessment should also consider mobility, chronic health conditions, muscle strength, and overall nutritional status, ensuring that each person’s needs are addressed on an individual basis.

Malnutrition Can Happen at Any Size
Being overweight does not guarantee good nutrition. An older adult can still be malnourished if their diet lacks essential nutrients - particularly protein. Without adequate nutrition, they may experience muscle loss, reduced immunity, and slower recovery from illness or injury.

Warning Signs of Unintentional Weight Loss
Any weight loss without trying should always be taken seriously, whether in aged care or the community. It may signal underlying illness, depression, swallowing difficulties, or inadequate access to nutritious food. Early assessment and intervention are critical. 

When Weight Loss is Necessary
In some cases, weight loss may be clinically recommended - for example, to improve mobility or ease breathing difficulties. In these situations:

• The approach should be slow and steady - no more than 1–2kg per month
• Plans must involve a multidisciplinary team including a doctor, dietitian, and physiotherapist or exercise physiologist
• The older person’s consent and input must be central to the process
• Protein intake should be maintained to protect muscle mass

Supporting Health, Dignity, and Quality of Life
Weight management for older people is not about dieting - it’s about promoting strength, independence, and overall wellbeing. The focus should always be on providing adequate nutrition, supporting muscle health, and ensuring mealtimes remain enjoyable and fulfilling.

By recognising the unique needs of older adults, care providers, families, and health professionals can ensure weight management strategies enhance health outcomes while respecting each person’s preferences and dignity.