OW2023: Pursuing Obesity KAER in Older Adults

For one of his fat-hating laugh lines, Bill Maher asks, “Have you ever have seen a fat 90-year old?” As a matter of fact, that describes a parent or grandparent for any number of our friends. It’s not really funny. It is merely one more way the empathy-challenged Maher betrays his ignorance about obesity. But obesity does have health effects that accumulate over the years. So the growing prevalence of obesity in older adults makes the obesity KAER model a valuable tool for primary care providers to help older adults recognize and cope with with obesity.

OW2023 started yesterday with a symposium jointly sponsored by the Obesity Society and the Gerontological Society of America to explore the GSA toolkit for obesity KAER.

Kickstart, Assess, Evaluate, and Refer

The paradigm for the KAER model for obesity in older adults should seem familiar. It has much in common with the Five-A’s framework for obesity consultations in primary care. In this case, the acronym tells providers to Kickstart a conversation and with consent, Assess the challenges obesity presents for the individual, Evaluate options for ongoing care, and Refer to community resources that can support a patient’s ongoing needs.

It is an elegant model that Jennifer Pettis, who presented in the symposium yesterday, describes as a valuable asset for primary care:

“It supports primary care providers to evaluate themselves and their staff for potential biases or false beliefs so that they can provide person-centered, evidence-based care for older adults with obesity.”

Gaps Remaining to Fill

In her presentation for the symposium, obesity medicine physician Fatima Cody Stanford emphasized the corrosive effects of bias and stigma that get in the way of delivering good care for older adults living with obesity. One way to overcome it is attention to implicit bias in the care team.

But we also need to fill in some knowledge gaps, said Stanford:

“We need to use a special lens to evaluate for issues like sarcopenia with obesity in the changing body of the older adult. We need clinical studies to evaluate pharmacotherapy, bariatric surgery, and lifestyle interventions better in older adult populations.”

So, no. Hostile jokes do not erase the fact that obesity is a condition that many older adults are living with. But a better KAER model can make life and health better.

Click here and here for more on the GSA toolkit for obesity care in older adults.

A Young and Old Woman from Bergen op Zoom, portrait by Albrecht Dürer / WikiArt

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October 15, 2023