Health and wellness coach Luke Coutinho recently shared the story of a 75-year-old woman who lost 12 kg in four months despite living with advanced liver fibrosis, diabetes and kidney concerns.Sharing her journey in an Instagram post, he wrote, “When Reenie came to us at 75, she had been living with diabetes for over a decade. In May 2026, she was diagnosed with advanced liver fibrosis, along with kidney concerns, high potassium and long-standing blood pressure issues. Her doctor recommended losing 10 kilos and starting low-dose Ozempic. But she was struggling with low energy, weakness, loss of appetite and anxiety about the medication. She wanted to lose weight, but more importantly, she wanted to feel healthy and strong again.”According to Coutinho, his team’s nutritionist and foundational medicine expert, Anita, worked alongside her doctor’s treatment plan to improve her nutrition, hydration, sleep and physical activity.He added, “We worked on balanced meals, adequate protein, complex carbohydrates, gut health, hydration, sleep and meal timings. No extreme restrictions. Just personalised changes that respected her medical needs, preferences and energy levels.”Her exercise routine gradually progressed from gentle walks to interval walking, Pilates, yoga and dumbbell-based strength training.DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.“Four months later, her weight had come down from 78 kg to 66 kg. That’s 12 kilos. But what makes us happiest isn’t just the number on the scale. It’s seeing Reenie feel energetic, confident and motivated again,” Coutinho wrote.Story continues below this adWhile her transformation highlights the importance of nutrition and physical activity, how safe is such weight loss for a 75-year-old with advanced liver fibrosis and other health complications?Dr Anand Ramamurthy, Director, Liver Transplant and Hepatobiliary Pancreatic Surgery, Jupiter Hospital, Thane, explains the medical precautions older adults should take before attempting to lose weight.Why does weight loss need medical supervision in older adults with liver disease?At 75, weight loss cannot be approached as a routine fitness goal, particularly when someone has advanced liver fibrosis, diabetes and compromised kidney function.According to Dr Ramamurthy, the first step is to assess the extent of liver damage, kidney function, blood sugar control and overall nutritional status.Story continues below this ad“We need to assess liver function, kidney parameters, blood sugar levels, muscle mass and whether there are signs of fluid retention or malnutrition,” he says.Advanced liver fibrosis can sometimes progress to cirrhosis, affecting how the body processes nutrients and maintains muscle mass.“Any weight-loss programme must be supervised by a hepatologist, with inputs from a dietitian and, where necessary, a nephrologist. The priority should be improving metabolic health without compromising muscle strength or liver function,” Dr Ramamurthy explains.He also cautions against attributing unexplained weight changes to lifestyle alone. At Jupiter Hospital, Thane, doctors recently treated a 48-year-old woman who had experienced recurrent hypoglycaemia for 14 months. Further evaluation revealed a small insulin-producing pancreatic tumour, called an insulinoma, which had contributed to significant weight gain. View this post on Instagram A post shared by Luke Coutinho – Official (@luke_coutinho) Is losing 12 kg in four months safe at 75?Reenie’s reported weight reduction amounts to more than 15 per cent of her initial body weight. However, Dr Ramamurthy says whether this is medically advisable depends on several factors, including the person’s starting BMI, muscle mass, overall health and how the weight was lost.Story continues below this ad“In older adults with liver disease, rapid weight loss can lead to muscle wasting, weakness and nutritional deficiencies,” he says.One particular concern is sarcopenia, or the loss of muscle mass and strength. This can worsen outcomes in people with advanced liver disease.“A gradual, monitored reduction is generally safer than aggressive weight loss. We must also establish whether the weight loss was intentional or unexplained, as unintended weight loss warrants medical investigation,” he adds.ALSO READ | Psychiatrist shares transformation photos after losing 33 kg, reveals the ‘hardest part’What should older adults with liver fibrosis and diabetes eat?Dr Ramamurthy recommends adequate protein to preserve muscle mass, with food sources and quantities chosen based on kidney function and individual nutritional needs.Story continues below this ad“Protein should not be restricted indiscriminately in liver disease,” he explains.A balanced diet should include vegetables, fibre-rich foods, controlled portions of complex carbohydrates and healthy fats. Excess salt, processed foods and sugary beverages should also be limited.Smaller, frequent meals and a nutritious bedtime snack may help prevent muscle breakdown, particularly in people with advanced liver disease.Which exercises are suitable for older adults with liver disease?Dr Ramamurthy recommends walking, light resistance training, chair-based exercises and balance activities as possible starting points, depending on mobility and medical fitness.Story continues below this ad“Strength training is especially important to preserve muscle mass. Exercise intensity should increase gradually, with supervision if the person has significant weakness or other complications,” he says.DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.