Obesity’s impact on the body often threatens mobility. This impact is compounded when aspects of the aging process also threaten an obese individual’s mobility and the ability to lead an independent life. In light of the likelihood of the combination of obesity and aging leading to mobility disability, researchers at the University of Florida reviewed the available research on obesity and aging to determine the most effective course of action for preventing the development of mobility disability among aging obese populations.
To combat mobility decline among obese older adults, the researchers recommended a combination of lifestyle management, pain and weight management, and nutritional adjustments. In terms of physical activity that can assist with mobility for obese older adults, the researchers caution that strength training should not focus on leg strength alone. New data from these researchers suggest that trunk muscles are also important for maintaining mobility, particularly if an individual is experiencing back or lower body pain. Research has shown that the contribution of trunk muscle exercises (such as those focusing on hip and lower back muscles) was similar to the effects of leg press exercises on scores on the Short Physical Performance Battery. Part of the reason for this improvement is that trunk exercises can strengthen the muscles surrounding a painful joint.
Pain is often a major obstacle to adherence to exercise and physical activity recommendations, and needs to be addressed in interventions for mobility in older obese individuals. For these individuals, pain associated with obesity is compounded by chronic pain related to aging, such as arthritis. In addition to the pain itself, there are psychological consequences of pain experiences that may need to be addressed. One of these is a tendency for an individual to focus on pain and negatively evaluate one’s ability to deal with pain. Another psychological impact of pain is a fear of moving due to worries about pain. This fear itself is a significant contributor to lower self-reported walking ability, even when other factors related to pain and obesity were taken into account. Individuals fared better on measures designed to measure mobility when they viewed testing as a challenge rather than a fearful event. In light of the psychological factors associated with pain and mobility, the researchers recommend finding ways to positively affect the perceptions of obese individuals. These can come from close friends or family members, or through professional assistance such as lifestyle change counselors or coaches.
The adoption of weight management strategies that take into account issues of pain and psychological concerns of this population is also recommended. Obese individuals can be provided with non-painful equivalents of some exercises, and participants can be guided through exercises in a way that minimizes the fear associated with movement or one’s ability to deal with “normal” pain.
Lastly, suggestions are made about the importance of attending to nutrition for this population. Paradoxically, among obese older adults, food intake declines while aging, even as fat deposits may continue to increase. In some cases malnutrition can become a risk. In light of this and the demands on the body of obese older adults, the researchers recommend paying attention to suboptimal dietary quality, with particular attention to ensuring sufficient protein and micronutrient intake.
Vincent HK and Mathews A. Obesity and mobility in advancing age: mechanisms and interventions to preserve independent mobility. Current Obesity Reports (2013); 2(3): 275–283.