Weight Management Program Aimed at Older Adults is Research Based

Wake Forest Baptist Program May Be One of a Kind

WINSTON-SALEM, N.C. - June 1, 2012 - A weight management program for older adults based on proven scientific data is possibly the first of its kind in the country and is offered by Wake Forest Baptist Medical Center.

Called Optimizing Weight for Life in Seniors, or OWLS, the program evolved several years ago from a research study that looked at weight management for older adults conducted by Barbara Nicklas, Ph.D. One participant didn't want the study to end.

"Many of them said we changed their lives, and there wasn't a program out there geared toward their age group," said Nicklas, a professor of geriatrics and gerontology at Wake Forest Baptist who specializes in and conducts research on weight loss and obesity consequences in the elderly.

OWLS is a specialty program for adults age 50 and over who are concerned about loss of physical abilities and independence. The program provides safe, evidence based, and effective evaluation and management for adults at risk for loss of physical function and mobility due to weight gain and muscle loss.

"Optimal weight is the goal of the program, but we are looking at these individuals as a whole and assessing their physical function, strength, endurance and nutrition health," Nicklas said. "We want to help them make changes in their health behaviors related to diet and physical activity to maximize physical function and prevent mobility difficulties."

While a 50-year-old can join a commercial weight loss program or a fitness center, what they don't get is an age-specific program that has scientific research to back it. Nicklas is not aware of any other geriatric obesity programs like this one.

"Other academic medical centers' aging programs may have clinics for different age-related conditions, but I think Wake Forest Baptist is the only one that has a specific weight loss program geared to older adults," Nicklas said.

Program participants undergo a comprehensive physical and metabolic evaluation that includes body composition, physical function, resting metabolic rate, physical activity, bone density test, dietary intake and a medical exam. The results are reviewed by a team that includes a geriatrician, a dietitian, an exercise physiologist and a researcher.

Geriatric obesity is on the rise with recent estimates showing that 35 percent of older adults are obese and another 33 percent are overweight and at risk for obesity, said Mary F. Lyles, M.D., a Wake Forest Baptist geriatrician who works with the program.

Lyles said there are several reasons why almost two-thirds of older adults are obese or at risk, ranging from changes in metabolic rates that occur with age to difficulty in changing lifelong dietary habits. An overall decline in movement and activity - especially when associated with chronic conditions such as arthritis - can also lead to weight gain.

"Most people gain weight with age - an average of one to two pounds a year - so that can add up over time," Lyles said. "Any of these factors can lead to even more rapid gain in the last decades of life, which can then cause additional problems."

The OWLS evaluation costs $850 or more, depending on the level of participation. The management program provides individual consultations with the dietitian and exercise physiologist, meal and exercise plans, and medical monitoring of conditions, such as diabetes, that are sensitive to weight changes and exercise habits. OWLS is a fee-for-service program for now, but last November Medicare approved payment of behavioral counseling for weight loss for older adults provided it takes place within a primary care doctor's office. So far, only five people have completed the program, but Nicklas is hopeful that at some point OWLS will be covered by Medicare as a health prevention service, making it a more affordable option.

For those who can't afford the individualized program or might achieve more success in a support group, there's also "My Turn," a lifestyle maintenance program designed to reinforce healthy behaviors. Weekly educational and coaching sessions with a registered dietitian and exercise physiologist are available. The cost is $300 for six months.

Exercise physiologist Elizabeth Chmelo, M.S., who works with the My Turn participants, said the group program partnered with the Clemmons YMCA and are planning to expand to other YMCA locations. The weekly educational/coaching meetings are held on site and participants are encouraged to take part in exercise classes. The YMCA's director of Active Older Adults, Nancy Miller, believed in the My Turn program so much, she signed up as a participant as well. "I thought this was certainly a fit for me. Yes, I wanted to lose weight so I jumped right in."

Four groups have been formed thus far with 31 participants like Kathi Vaughn completing the program. My Turn turned out to be just what she needed to get started. "I needed the accountability. I wasn't going to do it on my own," she said. "This hasn't been an overnight success. It's been a lifestyle change. The weight loss is great, but that's not the total measurement of success for me."

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