How Changing Bodies Require Changing Systems: The Intersection of Ageing and Obesity

By Elizabeth Lewis, Senior Policy and Project Coordinator at the International Federation on Ageing.

Obesity solutions require system-level approaches, but far too often they are discussed as personal failures.

Obesity uniquely impacts older adults, and ageing populations must remain central to policy and advocacy efforts.

The IFA is proud to support trailblazing initiatives addressing older adults and obesity in Canada, the United Kingdom and Australia.

Obesity solutions require system-level approaches, yet they are still too often framed as personal failures. What if obesity in later life is less about personal choice and more about the systems we build?

As we age, our bodies go through many expected physical changes that mark the years we have experienced life. Wrinkles, fine lines, and grey hairs appear, and we learn to adapt to our changing bodies. As we age, many experience internal changes as well: bones shrink in size and density, muscles can lose strength, and metabolism can slow down.

While our bodies go through many natural changes as we grow older, carrying excess weight can complicate or even speed up these changes, making it harder to lead a healthy, active life in our later years.

Many mainstream narratives discuss weight gain and obesity as individual failures. It is far too common to hear negative stereotypes associated with individuals living in bigger bodies, and it can become nearly impossible to avoid self-blame when experiencing weight gain.

However, obesity is increasingly recognized as a structural issue that is intimately connected to the social, economic, political, and environmental conditions in which we live. Beyond individual food and exercise decisions, obesity is impacted by system-level factors like limited access to safe places for physical activity, healthy and affordable food options, specialized and patient-centred forms of care, and failures to provide preventative and supportive healthcare at the policy level.

A Common Story

Imagine the following scenario:

Sarah, 72, has lived in a rural community all her life. She has typically spent her free time socializing with friends, gardening, and hosting family dinners. She spent over thirty years working as a retail cashier, raising her two children, and often making difficult decisions to live on her modest income.

Over the past couple decades, Sarah gradually gained weight, prompting her family members and doctors to encourage her to “eat healthier” and “exercise more”. It became more and more difficult for her to tend to her garden, and she began to swap home cooked meals for faster and more processed alternatives.

While Sarah has made autonomous lifestyle changes, the structural conditions that Sarah lived under made the reality of these changes not so simple. Fresh food was often more expensive than processed options, long shifts left little time or energy to cook, and her neighbourhood had few safe places to walk. Like many people, Sarah’s health was shaped not just by personal choices, but by the environments and systems around her.

Now in her seventies, Sarah lives with obesity and additional compounding health concerns. Subsequently, her independence, including walking to the bus stop, carrying groceries, or climbing stairs, has become much more painful and exhausting.

Sarah’s experience reflects how ageing and obesity intersect over the life course, influenced by factors such as income, food environments, healthcare access, and community design. Further, her story highlights that supporting healthy ageing requires more than focusing on individual responsibility, as it requires addressing the broader structural conditions and systems that shape health.

Change from the Bottom-Up through Civil Society Innovation

Believing in the importance of championing system-level changes and innovative solutions to obesity in older adults, the IFA, in non-commercial partnership with Novo Nordisk, launched a call to action on obesity and ageing in Canada, the United Kingdom and Australia. IFA received a wealth of proposals, all sharing a common goal to advance approaches to obesity amongst older adults. While there were many strong applicants, three projects stood out in their innovation.

Canadian Winner

Award Recipient Spotlight: Nymble Health

Congratulations to Dr. Megha Poddar of nymble health Inc, recipient of our Canadian award, for the innovative project “NymbleSilver: Targeted Digital Behavioural Support for Healthy Ageing in Older Adults Living With Obesity.”

Delivered through familiar platforms like WhatsApp and text messaging, the NymbleSilver program provides short, supportive conversations that offer behavioural coaching, education, and medical therapy tailored specifically for older adults.

Importantly, the program focuses on outcomes beyond weight, including strength, cognition, wellbeing, and confidence, while generating valuable real-world insights into how older adults experience obesity care.

Australian Winner

Award Recipient Spotlight: La Trobe University

We are proud to highlight an inspiring initiative from Dr. Jenna Lang of La Trobe University, Australia: “Prescribing for Function, Not Weight: Codesigning a Community Embedded Model of Obesity Care in Older Adults in Rural Australia.”

This project developed a Function-First Obesity Care Model, co-designed with general practitioners and community health partners in Shepparton, Victoria.

Rather than focusing solely on weight, the model prioritizes functional ability, independence, and quality of life, outcomes that matter most to older adults. By embedding an interprofessional approach within existing primary and community care systems, the initiative aims to create a sustainable, real-world solution that improves access to obesity care in rural setting.

United Kingdom Winner

Award Recipient Spotlight: International Longevity Centre-UK

We are pleased to spotlight an impactful initiative from Ms. Arunima Himawan of International Longevity Centre-UK: “Pushing the Overton Window: Solutions to Obesity in Older Adults.”

Through a multi-sector policy forum, the project will bring together stakeholders from healthcare, policy, employers, and community organizations to identify the most effective strategies for tackling obesity in later life. The outcome will be a practical policy guide outlining actionable solutions and “best buy” policy options.

By bridging the gap between ageing policy and obesity policy, this initiative aims to shift the conversation and drive meaningful, coordinated action across sectors.

The Future of Healthy Ageing

Addressing obesity in later life requires us to move beyond narratives of personal responsibility and toward solutions that recognize the complex systems shaping health across the life course. As populations age, policies, care models, and community environments must evolve to support older adults in maintaining function, independence, and wellbeing.

The innovative initiatives highlighted here demonstrate that meaningful progress is possible when civil society, researchers, and policymakers work together to rethink obesity through an ageing lens. By prioritizing system-level change and amplifying solutions designed with and for older adults, we can help ensure that healthy ageing is both achievable and equitable for generations to come.

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