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Ask Well: Is it more difficult for an older person to lose weight?

Yes, unfortunately. Although it is possible to lose weight at any age, several factors make it harder to lose weight with age.

Even those who remain active lose muscle mass every decade beginning in their 30s, research suggests, replacing it with fat. Muscles use up more calories than fat, so less muscle means a slower metabolism and the need for fewer calories, said Dr. Medha Munshi, a geriatrician and endocrinologist at Beth Israel Deaconess Medical Center in Boston.


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Declining levels of the sex hormones estrogen and testosterone, which typically start around the early 50s for women, with the onset of menopause, and somewhat later for men, compound the effect, said Dr. Munshi, who also directs the Joslin Diabetes Center’s geriatric diabetes programs.

People may also pay in late-middle age for weight they gained and lost in earlier decades, said Dr. Leslie Cho, an interventional cardiologist at the Cleveland Clinic. Weight gain changes metabolism, she said. A 60-year-old who now weighs 200 pounds but once weighed 300, for example, will need far fewer calories per day than someone of the same age and size who was never so overweight. Losing those fat cells, she explained, tricks the body into thinking it is starving and needs to hold on more tightly to calories consumed. “You do have to eat less to maintain that weight if you’ve been heavy,” said Dr. Cho, who also directs the Cleveland Clinic’s Women’s Cardiovascular Center.

Older people also tend to have more aches and pains and to be more sedentary, engaging in fewer physical activities.

Instead of obsessing about a number on a scale, Dr. Cho suggests that older people focus on general fitness. “It’s not about losing weight,” she said. “It’s about maintaining weight loss, but also about healthy eating and lifestyle.”

Adding muscle through weight training can also help speed up metabolism, or at least compensate somewhat for its decline, Dr. Munshi said. She tells her older patients that “you need it now more than you needed it at 25.” Eating more protein — but not more calories — may also help build or sustain muscle, she said. And she noted that many of her oldest patients end up underweight because they’ve lost their appetite along with their sense of smell, so food doesn’t seem appealing anymore.

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