OnDemand: Grand Rounds- April 2026: Beyond the BMI: Navigating Obesity, Aging, and GLP-1 Receptor Agonists-Navigating Obesity, Aging, and GLP-1 Receptor Agonists

Video Transcription

Video Summary

Dr. Tiffany Cortes gave a webinar on obesity management in older adults, focusing on how to balance the benefits and risks of GLP-1 receptor agonist therapy. She emphasized that older adults should not be treated as a uniform group and introduced the “4 M’s” framework: what matters most, medications, mentation, and mobility. The talk highlighted why weight loss should not be judged by pounds alone, since older adults with obesity may have sarcopenic obesity, osteosarcopenic obesity, or frailty, all of which increase risks of falls, disability, hospitalization, and death.<br /><br />She reviewed evidence showing that weight loss can reduce lean mass and bone mineral density, potentially worsening physical function and fracture risk. However, GLP-1 drugs may also have beneficial direct effects on muscle and bone. Dr. Cortes stressed the importance of assessing sarcopenia and fracture risk before initiating aggressive weight loss therapy, using tools such as SARC-F, grip strength, timed up-and-go, DEXA, and FRAX.<br /><br />To reduce risk, she recommended combining treatment with resistance exercise, adequate protein intake, and calcium/vitamin D supplementation. During the Q&A, she discussed limited data on muscle fiber changes, rising GLP-1 use in older adults, and the need for more evidence to guide safe, individualized treatment.

Keywords

obesity management

older adults

GLP-1 receptor agonists

sarcopenic obesity

osteosarcopenic obesity

frailty

bone mineral density

resistance exercise

sarcopenia assessment