Weight loss medications may help adults who are ages 65 years or older improve their health and manage obesity-related conditions. The benefits and risks depend on the drug, your overall health, and changes that occur with aging.
If you’re 65 years or older, you may wonder whether a weight loss medication is right for you. This article explains what to consider about weight loss medications, as well as their possible benefits and risks. It also provides key questions to ask your doctor before starting a weight loss treatment.
Note: If you have unintentional weight loss before starting a weight loss drug, it’s important to see your doctor. This could be a sign of another medical condition.
Carrying excess body weight in older age
Weight loss can improve many of these conditions. Still, individual health factors that change with age may influence whether weight loss medications are a safe option.
Aging leads to changes in
Some health conditions also play a role in whether certain medications are safe to take. Examples are heart disease, kidney disease, diabetes, and arthritis. Also, adding a weight loss drug to other prescribed treatments can increase the risk of drug interactions.
For older adults with obesity or weight-related health conditions, carefully managed weight loss can improve quality of life. When combined with a balanced eating plan and physical activity, weight loss medications
- reducing high blood pressure
- reducing high cholesterol
- improving blood sugar levels (in people with type 2 diabetes)
- improving mobility
- reducing strain on joints
- relieving symptoms of sleep apnea and other weight-related conditions
The benefits may outweigh the risks in older adults with obesity-related complications. And they might be worth considering when weight loss goals aren’t met through lifestyle changes alone.
The risks of weight loss medications in older adults depend on several factors. These include the drug, the person’s underlying health, and how weight loss occurs. Possible concerns for older adults include:
- loss of bone or muscle mass (or both) if weight loss is too rapid or not paired with resistance exercise (also called strength training)
- nutrient deficiencies if their appetite decreases without balancing nutrition, which can worsen existing vitamin B12, vitamin D, and protein deficiencies
- dehydration, dizziness, or digestive system side effects (such as diarrhea), which may cause new or worsened health problems
- hypoglycemia (low blood sugar) or hypotension (low blood pressure), which can affect people already taking medications for these conditions
- increased heart rate or increased blood pressure, which may carry a higher risk in older adults who have heart disease or take heart medications
Glucagon-like peptide-1 (GLP-1) receptor agonists are prescription drugs used for weight management and other conditions.
GLP-1 drugs work by slowing digestion and managing appetite. This can make it easier to eat less, leading to weight loss.
For some older adults, GLP-1 drugs can be safe and effective when a healthcare professional prescribes and monitors their use. But these drugs
- Digestive system problems, such as vomiting or diarrhea, that may lead to dehydration. In older adults, dehydration can cause dizziness, increase the risk of falls, and worsen kidney problems.
- Hypoglycemia (low blood sugar), especially when combined with other diabetes medications. Older adults may be more likely to experience confusion, fainting, or falls from low blood sugar.
- Gallstones, which are already more common with age. Treatment can require surgery, which may carry higher risks for older adults who have other health conditions.
Rapid weight loss with GLP-1 drugs may also lead to decreased muscle mass and osteopenia (lower bone density), increasing fracture risk.
Because of these possible effects, it’s important for older adults to have regular check-ins with a doctor while taking GLP-1 medications.
No specific weight loss medication is best for older adults. Doctors recommend a particular drug considering your treatment goals, medical history, and safety.
In addition to GLP-1 drugs, other options doctors sometimes
- Xenical (orlistat): This medication works by reducing the amount of fat the body absorbs. But it may cause digestive side effects, which may require adding vitamin supplements.
- Contrave (naltrexone/bupropion): This medication can help with appetite control. But it may not be safe for people who have certain heart or seizure conditions.
- Qsymia (phentermine/topiramate): This medication may be used in select cases. It requires monitoring for effects on the heart, mood, and sleep.
The only over-the-counter (OTC) weight loss drug approved by the Food and Drug Administration (FDA) is Alli (orlistat). Other OTC products, such as herbal supplements, fat burners, or detox teas, are not FDA approved. These products typically have little evidence of effectiveness.
Some OTC weight loss products can cause serious side effects or interact with prescription drugs. Always check with your doctor before trying any OTC weight loss product.
Physical activity
Helpful exercise activities for older adults include:
- resistance training, such as weightlifting or body weight exercises, to help maintain muscle
- low impact aerobic activity, such as walking, swimming, or cycling, to support heart health
- balance exercises, such as heel-to-toe walking, to reduce the risk of falls
Older adults with decreased mobility may find physical activity more difficult, but even light activity can help. A physical therapist or fitness trainer who has experience working with older adults can help you create a safe exercise plan.
If you’re considering a weight loss medication, you might want answers to these questions:
- Which weight loss medication might be safe and effective for me?
- How will this drug interact with my current medications?
- How much weight should I lose over a specific period of time?
- How will we monitor my muscle and bone health during the treatment?
- What diet pattern and physical activity plan should I follow while taking this medication?
Weight loss medications can be a helpful tool for some adults over 65 years of age, especially those who have obesity-related health conditions. But doctors do not recommend using them for all older adults. The safest and most effective approach usually combines:
- a weight loss drug
- healthy eating
- regular physical activity
- ongoing medical supervision
Before starting any weight loss medication, talk with your doctor about your health history, current medications, and goals. Together, you can create a treatment plan that supports safe weight management.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.