The senior patient and/or the geriatrician are confronted with a confusing literature describing how patients
interested in combating metabolic syndrome, diabesity (diabetes plus obesity) or simple obesity might best
proceed. The present paper gives a brief outline of the basic disease processes that underlie metabolic
pro-inflammation, including how one might go about devising the most potent and practical detoxification
from such metabolic compromise. The role that dietary restriction plays in pro-inflammatory detoxification
(detox), including how a modified fast (selective food abstinence) is incorporated into this process, is
developed. The unique aspects of geriatric bariatric medicine are elucidated, including the concepts of
sarcopenia and the obesity paradox. Important caveats involving the senior seeking weight loss are offered. By
the end of the paper, the reader will have a greater appreciation for the challenges and opportunities that lie
ahead for geriatric patients who wish to overcome food addiction and reverse pro-inflammatory states of
ill-heath. This includes the toxic metabolic processes that create obesity complicated by type 2 diabetes mellitus
(T2DM) which collectively we call diabesity. In that regard, diabesity is often the central pathology that leads to
the evolution of the metabolic syndrome. The paper also affords the reader a solid review of the neurometabolic
processes that effectuate anorexigenic versus orexigenic inputs to obesity that drive food addiction. We argue
that these processes lead to eitherweight gain orweight loss by a tripartite systeminvolving metabolic, addictive
and relational levels of organismal functioning. Recalibrating the way we negotiate these three levels of daily
functioning often determines success or failure in terms of overcoming metabolic syndrome and food addiction.