For weight loss in the elderly, purposeful weight loss is recommended for obese elderly with combined cardiovascular disease, type 2 diabetes, metabolic syndrome, and a BMI >30 kg/m^2. Studies on this population have found that the benefits of weight loss significantly outweigh the disadvantages. Weight loss goals: increase muscle mass, increase basal metabolic rate, decrease body fat rate, and improve overall mobility and quality of life. Weight loss in the elderly should be individualized based on their specific medical history and medication information, starting with exercise, diet, and medications. Regular exercise 1. weight-bearing plyometric exercise A combination of exercises that includes weight-bearing plyometric training is recommended for older adults. Plyometrics is the best way to avoid muscle loss and maintain bone density. Therefore, to lose too much visceral fat, maintain the muscle content of the obese elderly is the preferred way of exercise. Weight-bearing exercises are designed to bulk up muscles by lifting heavy objects repetitively and quickly, while plyometric exercises are designed to harden muscles by lifting heavy objects repetitively, slowly and in a controlled manner. Both exercises lead to increased muscle strength and need to be practiced together. In the beginning, it is recommended to go to a hospital for systematic evaluation and then under the guidance of a doctor or therapist to avoid sports injuries. Here the weights can use some exercise equipment, or at home using sandbags, dumbbells, elastic bands, etc., start to set a load of about 1-2 pounds, according to the body’s response, gradually increase the load, respectively, to practice the upper and lower extremities and key core muscle groups, 8-10 groups per day, each group repeated 10-18 times, 20 minutes each time, 2 hours per week. 2, other exercises Other exercise options: low to medium intensity aerobic training, flexibility training, balance training, with weight-bearing muscle training together, can enhance the weight loss effect. (1) low and medium-intensity aerobic training: walking, an aerobic exercise suitable for the elderly, is conducive to maintaining a good state of the heart, lungs and blood vessels, enhance bone density and lower limb muscle strength. Walking for 0.5-1 hour per day, the optimal pace is a bit of deep whistling and light sweating. You can also use a pedometer to record the daily steps while performing daily activities, which should accumulate up to 10,000 steps per day. Older people with arthritis can choose a form of exercise that is not stressful to the hip and knee joints, such as swimming, or walking in the pool for 30 minutes a day, is also a good form of aerobic training. (2) Flexibility training: It can improve the range of motion, flexibility and accuracy of the joints and ligaments of the elderly, and improve the performance of the bones against pressure and torsion, especially for the elderly who are at risk of falling. You can judge the flexibility of the body through a simple method: stand straight, legs together, bend down, touch the ground with the palms of your hands, pay attention to the knees do not bend: if the entire palm can completely touch the ground, indicating excellent flexibility; if the fingers can touch the ground, indicating very good flexibility; if the fingers can touch the back of their feet, indicating good flexibility. Otherwise, flexibility is poor and needs to be exercised. You can carry out a variety of fitness exercises and taijiquan that contain stretching, bending and rotating exercises. It should be noted that the exercise should be slow and gradual, the pulled muscle ligaments can have a slight discomfort, can not be rushed to cause pain, to prevent strain on the muscle ligaments, damage to the joints. It is recommended to do flexibility exercises for 15 minutes a day. (3) balance training: can enhance the ability of the elderly to control the body, reduce the occurrence of falls, hip, wrist and waist injuries. For example, leg lifting exercises, single-leg standing exercises, four-point support exercises on hands and knees, standing exercises with eyes closed, etc.. Note: Exercise should be from easy to difficult; practice in the open-eyed state first, and gradually transition to closed-eyed practice; gradually increase the transfer of weight and swing, the amplitude should be small to large, and the speed should not be too fast; when exercising at home, there should be someone next to protect; to keep away from furniture and other hard objects to prevent loss of balance and injury. Elderly people who have balance disorders due to injury or illness should exercise under the guidance of professionals. It is recommended to do balance exercises for 15 minutes every day. 3, high protein diet Research found that for the elderly with less muscle type obesity, high protein diet is more suitable for this group than ordinary protein diet. High protein diet can produce greater fat consumption, especially visceral fat, can optimize muscle protein synthesis, prevent muscle weakness fall, increase satiety, achieve the goal of appetite control, weight loss, reduce the risk of chronic metabolic diseases, and can provide a large number of essential nutrients. It is recommended that 1.2-1.6g of protein/kg/day, that is, for elderly people weighing 60kg, the daily consumption of protein should be between 72-96g, and the consumption of protein should account for 25-30% of the total daily diet. Lean poultry meat, fish, and 300ml of low-fat milk per day are good choices. For elderly people who have difficulty chewing, beans and eggs can be chosen instead of lean meat. Among the three meal distribution methods, it should be noted that: breakfast should be sufficient protein (not less than 35g), which can increase the feeling of fullness throughout the day; eating breakfast can reduce the need for unhealthy snacks in the evening; skipping breakfast can significantly increase weight, so elderly people must pay attention to eating breakfast; if lunch can be supplemented with sufficient protein (>48g), it can produce stronger muscle synthesis effect. In addition, for postmenopausal women and the elderly, 1000 mg of calcium daily (including dietary calcium) and 400-800 IU of vitamin D are essential supplements to maintain bone health. Medications that may cause weight gain Weight loss may involve medication adjustments, so it is always recommended to provide a thorough medical history and medication information to your doctor. The following are medications that can cause weight gain, and if you intend to lose weight, ask your doctor if you can replace them with other medications: antiepileptics: gabapentin antipsychotics: olanzapine antidepressants: tricyclic antidepressants hypoglycemic agents: sulfonylureas, thiazolidinediones beta-blockers steroid hormones Summary Obesity in the elderly is on the rise, due to the special body fat distribution characteristics of the elderly –muscle less type obesity, the weight loss methods of middle-aged and young people are not applicable to the elderly. Although there is still no clear definition and treatment guidelines for obesity in the elderly population, the promotion of a healthy lifestyle and safe exercise within the limits of one’s ability is indisputable to improve the overall mobility and quality of life of the elderly.