Abstract
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The
prevalence of obesity has reached dramatic proportions over recent years, and
obesity among older adults is becoming an increasingly important concern in
developed countries with ageing populations. Weight loss is recommended for all
obese individuals, regardless of age, yet while there has been a vast amount
of research into factors surrounding weight loss across younger and
middle-aged populations, the evidence base on weight loss in older adults is
lacking. This thesis uses data from a cross-sectional survey of UK adults,
and two large epidemiological studies of ageing, the English Longitudinal
Study of Ageing and the Health and Retirement Study in the US, to address
this gap in the literature. Study 1 highlights the high prevalence of desire
to weigh less and attempts at weight loss among older adults, and Study 2
reveals that a surprisingly high proportion of those who are overweight or
obese are achieving clinically meaningful (≥5%) weight loss. Studies 3 and 4
show that despite reductions in cardio-metabolic risk, weight loss in
overweight/obese older adults is associated with increased risk of depressed
mood, and this association grows stronger with each decade of age. However,
Study 5 finds some evidence to suggest that rates of depressed mood might
only be increased during the process of weight loss, and that if weight loss
is maintained there might be benefits for mood relative to baseline. This
research contributes to the understanding of weight loss in older adults -
particularly that which occurs in the general population, outside of the
trial context - and emphasises the need for health professionals to take into
consideration patients' psychological wellbeing when recommending or
responding to weight loss at older ages. Limitations of this work and
directions for future research are discussed.
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