A healthy weight and BMI range for adults over age 65 may mean carrying a few extra pounds. According to the National Institutes of Health, a body mass index (BMI) of 25 to 27, which is typically considered overweight, may offer bone health benefits and protect against osteoporosis.
Some studies also show that being underweight can increase the risk of death, disability, and dementia. In other research, extra weight (possibly due to better nutrition) may offer benefits in people with specific health conditions, including cancer or heart failure.
BMI is a dated, flawed measure. It does not take into account factors such as body composition, ethnicity, sex, race, and age. Even though it is a biased measure, BMI is still widely used in the medical community because it’s an inexpensive and quick way to analyze a person’s potential health status and outcomes.
How BMI Affects Older Adults
There are certain risks associated with having a high BMI at any age. These include:
But a low BMI is also unhealthy, especially for older adults. This has led some experts—including the National Institutes of Health—to suggest that an ideal BMI for older adults is between 25 and 27. That compares with a healthy BMI for younger adults over age 20, which is between 18.5 and 24.9, with a BMI of 25 to 29.9 considered overweight.
A Healthy Weight for Older Adults
Research published in 2023 was based on 58 studies that included more than 1.1 million people ages 65 and older. Its focus was the “obesity paradox,” in which extra weight may have a protective effect in older adults but leads to health risks in younger adults. Results include:
- More than half of the studies found evidence for a protective effect in older adults, especially when serious medical problems arose.
- The authors note there were mixed results depending on age. For example, extra weight appeared to offer a benefit to people aged 75 or older who were diagnosed with an atrial fibrillation heart arrhythmia but not those between ages 65 and 74.
- The authors note mixed results depending on diagnosis. Weight didn’t help the death rate for people hospitalized with COVID-19, but it did with hip fracture and sepsis infection. Results on cancer were mixed.
The 2023 research follows older studies that identified an increased risk of death in older adults when BMI was below 23 or above 33. Taken together, the healthiest weight for older adults may fall between BMIs of 25 and 27, maintained with a healthy diet and regular exercise.
Waist Circumference and Wellness
A person’s waist circumference may be able to predict the risk of certain health conditions that occur later in life. For example, when more fat accumulates in the waist instead of the hips, it can signal a higher risk of experiencing heart disease and type 2 diabetes. These risks are heightened in women with a waist size larger than 35 inches and in men with a waist size larger than 40 inches.
Weight Chart for Older Adults
The following chart includes a range of BMIs for older adults, ordered by height. Included here are underweight, ideal weight, and overweight BMIs, based on guidelines provided by the National Institutes of Health, and research published in the American Journal of Clinical Nutrition.
Height | Underweight (BMI <23) | Ideal Weight (BMI 25-27) | Overweight (BMI >33) |
4’10” | <110 | 119 to 129 | >158 |
4’11” | <114 | 124 to 133 | >163 |
5’0″ | <118 | 128 to 138 | >168 |
5’1″ | <122 | 132 to 143 | >174 |
5’2″ | <126 | 136 to 147 | >180 |
5’3″ | <130 | 141 to 152 | >186 |
5’4″ | <134 | 145 to 157 | >192 |
5’5″ | <138 | 150 to 162 | >198 |
5’6″ | <142 | 155 to 167 | >204 |
5’7″ | <146 | 159 to 172 | >211 |
5’8″ | <151 | 164 to 177 | >216 |
5’9″ | <155 | 169 to 182 | >223 |
5’10” | <160 | 174 to 188 | >229 |
5’11” | <165 | 179 to 193 | >236 |
6’0″ | <169 | 184 to 199 | >242 |
6’1″ | <174 | 189 to 204 | >250 |
6’2″ | <179 | 194 to 210 | >256 |
6’3″ | <184 | 200 to 216 | >264 |
6’4″ | <189 | 205 to 221 | >271 |
Calculate Your BMI
BMI is a measure of your weight relative to your height. It’s calculated by dividing your weight in kilograms by your height in meters squared.
If you don’t know your BMI, you can use the following BMI calculator to find out.
Benefits of a Higher BMI
Several studies have found that being underweight at age 65 was linked to poor health and shorter life expectancy. Being overweight or obese at 65 was only rarely linked to worse health outcomes or lower life expectancy compared to those who were at a healthy weight at age 65.
Studies on specific benefits suggest:
- Social and emotional health: A Korean study collected data based on interviews with 542 people who had an average age of 74. Scientists discovered that health-related quality of life factors, such as social functioning, emotional health, and pain, are not made worse by a higher BMI in older adults.
- Better cognition and functioning: A study of the Colombian population found that being underweight has been associated with reduced cognitive performance and daily functioning. Additionally, being overweight but not obese was associated with better cognition and daily functioning.
Older adults who do not have a low BMI also may enjoy a more active and independent lifestyle. However, some studies find that both obesity and being underweight can lead to frailty.
Risks of Lower BMI
A low BMI decreases your chances of recovering from illnesses and infections. For example, underweight stroke survivors have worse outcomes than stroke survivors who are overweight or average weight. Being underweight increases the risk of developing health problems, including nutritional deficiencies that cause medical problems such as osteoporosis.
Many conditions, such as cancer, gastrointestinal disease, and neurological disease, can prevent older adults from eating or absorbing nutrients. This may lead to a low BMI, often unintentionally and for the first time in their lives.
Weight Maintenance Goals
When trying to stay healthy, you should work with a healthcare provider. Despite what charts and calculators may say, the target BMI is not the same for everyone. Weight loss (or gain) may be a sign of a health issue that requires diagnosis and treatment.
You may need to factor in additional considerations, such as:
- Health issues such as anemia or diabetes, with specific diet and nutrition concerns
- Changes in activity level due to age or health
- Medications
- Metabolism changes
A nutritionist can help to guide you as you set your calorie goals. Nutritionists can also help you decide whether you need to take vitamin and mineral supplements.
How Older Adults Can Gain Weight
- Add foods with a high calorie-to-volume ratio into the diet, including nuts, nut butters, avocados, dried fruit, whole grains, pasta, chocolate, cheese, and full-fat dairy.
- Eat five to six smaller meals per day rather than the traditional three.
- Eat 1 gram of protein per day for each kilogram of body weight.
- Drizzle extra virgin olive oil over food. It delivers 887 calories per 100 grams.
- Prepare high-calorie meals, such as casseroles, in bulk, or sign up for a meal delivery service so that food is always on hand.
- Speak to your healthcare provider about any nutritional supplements you may need.
Summary
Healthcare providers recommend most adults keep their BMI between 18 and 24.9. Adults with a BMI over 25 are considered overweight and a BMI over 30 is considered obese. Older adults, though, do better if they have a BMI between 25 and 27. Research shows that adults over 65 who are underweight experience more health issues and shorter life expectancy.
There are no official recommendations on what the ideal weight range or BMI should be for people over 65, but it’s important to avoid weight loss due to illness or poor nutrition. Your healthcare providers can help you determine the best diet plan for your health and help to improve your nutrition.
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