Obesity in older persons: A crisis in rural america

The Geisinger Health Care System serves one of the largest concentrations of rural elderly in America. The present study examined the frequency of obesity among free-living older persons enrolling in a managed health care program. A modified Level II Screen (Nutrition Screening Initiative) was completed on more than 3,000 subjects during a required visit at any of more than 50 primary clinic sites. Demographics reveal a young elderly population (70 ± 6.2 years) split nearly evenly between the sexes. Body weights (kg) were 83.9 ± 14.5 and 74.5 ± 15.1 for males and females, respectively. Both sexes tended to overestimate height and underestimate weight. Body mass indices (BMI, kg/m²) were 28.1 ± 4.9 for males and 29.7 ± 5.9 for females. Those exceeding a BMI threshold of 30 kg/m² were 30% for males and 43% for females. A 4.5 kg weight gain over the preceding 6 months was reported by 7% of males and 11% of females. Since morbid obesity in older persons may be associated with medical comorbidities and functional compromise, it is essential that screening and intervention efforts emphasize these concerns.