ometendoОжирение и метаболизмObesity and metabolism2071-87132306-5524Endocrinology Research Centre10.14341/omet12919ometendo-12919Research ArticleОБЗОРЫREVIEWSОжирение у пожилых людей: особенности ведения в амбулаторной практикеObesity in the elderly: peculiarities of treatment in outpatient practicehttps://orcid.org/0000-0001-9253-8075СуплотоваЛ. А.SuplotovaL. A.

Суплотова Людмила Александровна, д.м.н., профессор 

625023, г. Тюмень, ул. Одесская, д. 54

Lyudmila А. Suplotova, MD, PhD

54 Odesskaya st., 625023, Tyumen

suplotovala@mail.ruhttps://orcid.org/0000-0002-1232-3806АлиеваО. О.AlievaO. O.

Алиева Оксана Олимжоновна 

г. Тюмень

Oksana O. Alieva

Tyumen

dr.alieva@inbox.ruhttps://orcid.org/0000-0002-6329-593XДушинаТ. С.DushinaT. S.

Душина Татьяна Сергеевна 

г. Тюмень

Tatiana S. Dushina

Tyumen

dr.dushina@mail.ruhttps://orcid.org/0000-0003-4663-0289МакароваО. Б.MakarovaO. B.

Макарова Ольга Борисовна, к.м.н. 

г. Тюмень

Olga B. Makarova, MD, PhD

Tyumen

dr.makarova@yahoo.comТюменский государственный медицинский университетРоссияTyumen State Medical UniversityRussian Federation202306062023202140148Copyright © Суплотова Л.А., Алиева О.О., Душина Т.С., Макарова О.Б., 20232023Суплотова Л.А., Алиева О.О., Душина Т.С., Макарова О.Б.Suplotova L.A., Alieva O.O., Dushina T.S., Makarova O.B.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.omet-endojournals.ru/jour/article/view/12919

На сегодняшний день прослеживается общемировая тенденция старения населения, кроме того, увеличивается доля пожилых людей с ожирением. С целью адекватного ведения этих пациентов на амбулаторном этапе крайне важно понимать динамическую взаимосвязь между массой тела, распространенностью хронических заболеваний, развитием функциональной нетрудоспособности, продолжительностью жизни, а также расходами на здравоохранение. Хотя эпидемия ожирения охватила людей всех возрастных групп, эмпирические знания об особенностях ведения пожилых людей с ожирением остаются в значительной степени скудными. В настоящее время не существует единого терапевтического подхода к данной проблеме. Следует относиться с осторожностью к снижению веса у людей старше 60 лет. Необходимо учитывать опасность саркопении, мальнутриции, потери костной массы, повышенного риска падений и травм, которые могут привести к росту количества людей с инвалидностью и связанных с этим расходов на медицинскую и социальную помощь. Аналитический обзор посвящен взаимосвязи двух величайших эпидемиологических тенденций: старения и ожирения. В данной работе освещены особенности патофизиологии ожирения в пожилом возрасте, феномен «парадокса ожирения». Также с позиции доказательной медицины проанализированы подходы к лечению ожирения в пожилом возрасте, включая хирургические вмешательства, направленные на снижение массы тела.

Today there is a worldwide trend of population aging, in addition, the proportion of older people with obesity is increasing. In order to adequately manage these patients in the outpatient setting, it is critical to understand the dynamic relationship between body weight, chronic disease prevalence, development of functional disability, life expectancy, and health care costs. While the obesity epidemic has affected people of all age groups, empirical knowledge about the management of obese older people remains largely scarce. Currently, there is no single therapeutic approach to this problem. Weight loss should be treated with caution in people over 60 years of age. The risk of sarcopenia, malnutrition, bone loss, increased risk of falls and injury must be considered, which can lead to an increase in the number of people with disabilities and the associated costs of medical and social care. The analytical review focuses on the relationship between two of the greatest epidemiological trends: aging and obesity. This paper highlights the features of the pathophysiology of obesity in the elderly, the phenomenon of the «obesity paradox». Also from the perspective of evidence-based medicine approaches to the treatment of obesity in the elderly, including surgical interventions aimed at reducing body weight, are analyzed.

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The authors declare that there are no conflicts of interest present.