Obesity and associated lifestyle in a large sample of multi-morbid German primary care attendees

Aims: Obesity and the accompanying increased morbidity and mortality risk is highly prevalent among older adults. As obese elderly might benefit from intentional weight reduction, it is necessary to determine associated and potentially modifiable factors on senior obesity. This study focuses on multi-morbid patients which make up the majority in primary care. Methods: A total of 3,189 non-demented, multi-morbid participants aged 65–85 years were recruited in primary care within the German MultiCare-study. A healthy lifestyle score (HLS) was introduced. Body Mass Index (BMI, general obesity) and waist circumference (WC, abdominal obesity) were used as outcome measures. Results: About one third of all patients were classified as obese according to BMI. The prevalence of abdominal obesity was 75%. Adjusted for sociodemographic variables and disease burden, participants with the highest HLS displayed a lower BMI (–0.7kg/m², p<0.016) and WC (–4.3 cm, p<0.001). Additionally, in multivariate regression, higher subjective and objective health-related impairment were associated with lower WC and BMI. For individual lifestyle choices, higher physical activity (β=1.111; p<0.01) and current smoking (β=–1.543; p<0.01) were associated with BMI. Conclusion: Assessment of WC as a measure of obesity in multi-morbid elderly seems inevitable in order to identify individuals at risk. Yet, age-specific thresholds for the BMI are needed likewise. The general practitioner plays an essential role in delivering weight counseling to older patients and is able to assess relevant lifestyle choices. Encouraging and promoting physical activity in older adults might a starting point for weight reduction efforts.