If you’ve grown up believing that a BMI between 18.5 and 24.9 is the ultimate indicator of good health, you may be surprised to discover that things change somewhat after the age of 65. Having a little extra padding in your older age may not be such a bad thing—in a few situations, it could even be a plus. Let’s take a closer examination of what the research reveals about healthy weight for older adults and why our method regarding BMI may require a reconsideration as we get older.
Rethinking “Healthy Weight” After 65
Most adults have learned the general BMI ranges: below 18.5 is underweight, 18.5 to 24.9 is normal weight, 25 to 29.9 is overweight, and 30 or higher is obese. But the numbers don’t always present the complete picture, particularly with older individuals. In recent years, research has found that individuals over 65 who are categorized as “overweight” on the BMI scale tend to do as well as—or even better than—their slimmer counterparts.
The Centers for Medicare & Medicaid Services, for example, recommend a BMI range between 23 and 30 for older adults. Some studies go a step further, suggesting that a BMI between 25 and 27—or even up to 35 in some situations—might be more appropriate for maintaining strength, independence, and resilience in later life.
Why Being Underweight Can Be Risky
Being too thin later in life isn’t only about looks—it is an indicator of more serious health problems. Low weight in older adults correlates with reduced recovery after sickness, increased risk of infection, and even decreased longevity. Stroke survivors, for example, who are underweight tend to fare poorer than those who carry a little excess weight. A low BMI can also indicate nutritional deficiencies that can cause conditions such as osteoporosis and compromised immunity.
It is not unusual for older people to gain weight unintentionally, particularly if they have health conditions such as cancer, digestive disorders, or neurological illnesses. That is why sudden or unexpected weight loss in elderly people should be taken seriously—it could be an indicator that the body is not receiving what it needs.
The Surprising Upside of a Few Extra Pounds
Here is where it gets fascinating: being a bit overweight in your older age may provide some benefits. One Korean study discovered that elderly individuals with higher BMIs indicated similar—or even superior—emotional and social well-being. Another study revealed that individuals who were overweight (not obese) scored better on everyday activities and mental tests.
Having a bit of extra weight can act as a buffer against illness or after surgery, providing the body with extra energy to draw upon while it recuperates. That being said, there is a point at which it ceases to be helpful—being severely overweight or obese can still contribute to mobility problems, a higher risk of falls, and a higher likelihood of becoming frail or dependent.
Obesity in Older Adults: The Double-Edged Sword
While a little extra weight may be beneficial, obesity still has serious health consequences, regardless of age. Adults with high BMIs (particularly above 35) are more likely to experience conditions such as high blood pressure, diabetes, sleep apnea, and arthritis. Obesity may also complicate surgery and prolong recovery.
But here’s a catch. Other research indicates that older people with mild obesity have improved survival after some diseases or surgeries. This so-called “obesity paradox” implies that weight and health are more nuanced at older ages than we had realized. Nevertheless, the negative effects of severe obesity—such as diminished mobility, falls, and side effects from medicine—are quite real and shouldn’t be ignored.
There’s More to Health Than a Number
BMI is useful, but it’s only part of it. It won’t reveal whether you have a lot of muscle or fat on yourbody, or where the fat is distributed. For older adults in particular, maintaining muscle mass is just as important as maintaining a steady weight. Measures such as grip strength or calf circumference can provide a better indication of overall health and frailty risk.
Other pieces of the puzzle are your weight history, recent changes, physical activity, medical conditions, medications, and—even more importantly—how you feel day to day. The true goal for most older adults isn’t to pursue a certain number, but to stay at a weight that enables them to remain active, independent, and feeling good.
What’s the Right Weight for You?
So what does this all mean in practice? For many older adults, a BMI between 25 and 35 may be perfectly healthy. Some research even points to an ideal range of 27–28 for men and 31–32 for women. But the “best” weight is the one that supports your strength, energy, and ability to enjoy life.
If you’re seeing changes in your weight—whether increasing or decreasing—it’s worth checking with your doctor or dietitian. They can assist you in getting a wider overview of your health, from nutrition to activity levels and all points in between. And don’t forget: with aging well, sometimes an extra cushion is a very, very good thing.