Weight loss drugs show promise, and risks for older adults

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For many adults over 65, the motivation to lose weight looks very different from that of younger people. Instead of focusing on aesthetics, older adults are often driven by practical goals tied to daily function and overall health, according to Dr. Alissa Chen, an instructor of medicine at Yale School of Medicine.

“Their goals are usually aimed at improving outcomes—like being able to walk longer distances without knee pain or getting on the floor to play with their grandchildren,” Chen said. 

Many are also interested in weight loss medications because of their potential to help manage related conditions such as heart disease or sleep apnea.

The role of medication

Chen studies obesity in older adults and how medications can support individualized treatment goals. She is the first author of a recent systematic review that highlights a major gap in obesity research: a lack of data on how anti-obesity medications affect adults aged 65 and older.

The review found that older adults taking these medications experienced gastrointestinal side effects more frequently than younger populations and were more likely to stop taking the drugs altogether. The findings underscore the need for larger, more comprehensive studies to better inform clinical care for this growing population.

“Our approach to the treatment of obesity in older adults should be inherently different given that they have different medical needs and goals,” Chen said. “If we can better understand those needs and goals, we can provide older adults with obesity with the care they need.”

Safety is a major issue

Safety is a particular concern, as older adults are more likely to take multiple medications, increasing the risk of harmful interactions. Chen noted that some weight loss drugs, including glucagon-like peptide-1 receptor agonists (GLP-1s), may raise the risk of dehydration and falls in older patients.

“These medications are transforming obesity care, but we still don’t have clear evidence on how they perform in people over 65, who often have different risks and vulnerabilities,” said Dr. Kasia Lipska, associate professor of medicine and senior author of the study. “Understanding safety in this group is essential before we scale up use.”

Lipska added that obesity in older adults reflects a lifetime of health history, social influences, and age-related changes in muscle and metabolism. As a result, she argues, it should be studied as its own condition rather than an extension of midlife obesity.