Unintentional Weight Loss in Older Women: Causes and Health Risks

So what are some of the reasons why people may lose weight? Well, there is a condition called aging anorexia, which is kind of a total body phenomenon of weight loss caused by a number of different possible factors as we get older.

And it is implied to affect about as many as 30% or 50% of people, depending on the setting that we're talking about. Have you made it past menopause, or are you going through it now?

I'm Dr. Pat McShane, and on the Women's Health Span Voices podcast, I'll guide you through the health challenges of the menoppausal years and beyond, guiding the way to thriving in this powerful era of your womanhood.

Welcome to Women's Houseband Voices. I'm Dr. Pat McShane. Usually people are talking about weight gain and trying to lose weight. Today we're going to have a little different perspective, which is as we get older, many of us actually lose weigh unintentionally and what are some of the various clinical scenarios that's implied in that situation and how we might think about them and respond to them.

So just a little bit of background, the average American woman is 5 foot 3 inches tall and weighs 170 pounds, which would be considered overweight. And we reach our maximum weight around 100 and in our early 50s rather, and then after that tend to lose weight or drop our weight.

One issue with this is that much of the weight that we lose is from our muscle. And we're going to come back and talk about that a little bit more. So what are some of reasons why people may lose weight?

Well, there is a condition called aging anorexia, which is kind of a total body phenomenon of weight loss caused by a number of different possible factors as we get older.

And it is implied to affect about as many as 30% or 50% of people, depending on the setting that we're talking about. If we are talking people who are independently living, one level may be seen if people are in an institution or a nursing home, then it may a different number because of the availability of food and companionship and so on.

So that's just a general outline of the issue and why do people, women in particular, and this affects women disproportionately to men, why might women be especially prone to losing weight as they get older?

Well, a lot of it is hormonal and physiological and some is social and we'll talk a little bit about those various things. From a hormonal perspective, there are a number of hormones that are active throughout our gut, and that is about our appetite, our satiety, or digestion, are absorption of the minerals and so on.

And then the end product of all of that, is our metabolism. Those tend to become less efficient as we get older and function differently. So we may, for instance, have gastric paresis.

Our stomachs don't function as efficiently and as quickly. So, we feel full with less food being in our stomach. And it stays in there longer, so we're not getting the hunger sensation as quickly because we may still have some residual food in our stomachs.

And that's just one example. The entire gut has various mechanisms similar to that, and we are not going to go into detail today about what those mechanisms are or how they might be treated.

But that is certainly one factor. Another factor is our taste may be diminished and that again may related to aging alone. It may medications that we are taking and it may have to do with the kind of food that's available to us.

If we're having to kind forage for our own food, we may not have access to the foods that find the most palatable. and so on. So, we may just be eating less because it's not as satisfying to us emotionally based on our sensation of the flavor of food and, so, on socially.

If we're not having companionship with our meals, uh, We may be less inclined to eat at all or eat different kinds of foods and So on if we are limited in our mobility, having to have trouble getting together our meals or cooking our meal.

And that's a big issue for older people with less energy oftentimes. So that is another big one that related to social isolation and lack of companionship.

As I mentioned, this is a common issue and it may lead to loss of muscle mass which then in turn leads to frailty which is associated with a higher rate of mortality.

So this can be a very serious medical situation that needs to be delved into and again the diagnosis may vary depending on the condition of the individual woman, but certainly something to be aware of.

And I'm distinguishing this today from eating disorders that affect older women. Just as younger women may be impacted by eating disorder, oftentimes someone who has had marginal treatment of their eating in their earlier years may show up with a new version of it, if you will, in there senior years as they undergo menopause.

And just to back up a little bit, an eating disorder is defined as a serious mental and medical health condition defined by serious disturbances in eating behavior and an intense distressing preoccupation with food, body weight, and shape.

And under the umbrella of eating disorder is anorexia, bulimia which is eating and binging typically and purging rather not binging and binge eating. So anarexial is preoccupation with calories and over exercising to compensate in many instances, not in every case.

This is not constrained to younger women. It's found in both men and women as well as in senior women. And the same issues regarding the downstream impact of what's often termed menorexia pertain as with aging, aging anorexy, which is loss of muscle, loss a bone also, and frailty.

The women with purging, actual vomiting and induced vomiting, may have a whole set of medical conditions related to that, some hormonal and electrolyte abnormalities and so on.

So it can be a fatal disorder in early life and also in later life. Again, something to be very aware of. Besides rekindling of an older eating disorder issue as we get older, there are a lot of factors that appear to bring on eating disorders in older women.

And the hormonal changes of menopause are certainly among them. Most of us notice change in our body shape as are simultaneously gaining weight. in our menopause transition, and so that may cause an eating disorder to flare up that might not have been so severe in earlier life.

And often social stresses such as death of family members or spouse, divorce, infidelity of a spouse and then our overall issue of what body image means in our current culture.

This can play a big role as well. So, a lot to be concerned about here, and again, something to look at and work up. Another association is just with depression, the diagnosis of depression which is Fairly common in both young and older women.

It's not something that goes away Typically as we age so and depression may present as anorexia Just inability to eat lack of appetite and so on So, again, a lot to be aware of here and reasons to seek medical care.

There definitely are approaches that can be useful for these conditions, both the anorexia of aging and also eating disorders in aging. And it's worthwhile checking out if you're having weight loss or have concerns about the symptoms of eating disorders, check it out with your medical professionals.

And I hope that you get some good answers and good help if this is a problem that You've been having. So if This kind of information appeals to you, please like and share with Your friends so that we can get the word out to more women.

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