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Weight-loss intention in the well-functioning, community-dwelling elderly: associations with diet quality, physical activity, and weight change^1,2,3

¹ From the University of Pittsburgh (JSL and ABN); Wake Forest University, Winston-Salem, NC (SBK); the University of Tennessee, Memphis (FAT); the National Institute on Aging, Bethesda, MD (TH); the National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (JE); the Intramural Research Program, National Institute on Aging, Baltimore (EMS); and the University of California, San Francisco (SMR)

Background: Many older adults desire to lose weight, yet the proportion with a health-related weight-loss indication, weight-loss strategies, and success is unknown.

Objective: We examined the associations of reported intention to lose weight with health-related indications for weight loss, diet quality, physical activity, and weight-loss success in well-functioning older adults.

Design: This prospective, community-based cohort included 2708 elderly persons aged 70–79 y at baseline. We determined indication for weight loss by using the modified National Institutes of Health guidelines, diet quality by using the Healthy Eating Index, and weight-loss intention and physical activity by using questionnaires. Measured weight change over 1 y was assessed.

Results: Twenty-seven percent of participants reported an intention to lose weight, and 67% of those participants had an indication for weight loss. Participants who reported a weight-loss intention were heavier than those who did not, had more depressive symptoms, and were more likely to be dissatisfied with their weight, regardless of weight-loss indication. Participants with an intention to lose weight reported better eating behaviors and a more active lifestyle than did participants without a weight-loss intention, independent of other health conditions. No significant difference in actual weight loss was found between participants intending and not intending to lose weight, regardless of indication for weight loss.

Conclusions: Despite being associated with healthier behaviors, the intention to lose weight did not predict greater weight loss in this well-functioning elderly cohort. More attention needs to be focused on the necessity and efficacy of specific strategies for weight loss in older adults.

Key Words: Weight-loss intention • weight-loss indication • diet quality • physical activity • Health ABC study

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