Bariatric surgery after age 60 is safe and effective

Bariatric surgery in patients age 60 and older is safe and effective, producing results comparable to those seen in younger adults, according to researchers from the Geisinger Medical Center in Danville, PA, who presented their findings today at Obesity Week 2017, the largest international event focused on the basic science, clinical application and prevention and treatment of obesity. The annual conference is hosted by the American Society for Metabolic and Bariatric Surgery (ASMBS) and The Obesity Society (TOS).

The study analyzed data on 367 patients age 60 or older who had either sleeve gastrectomy (32 patients), or open (115 patients) or laparoscopic Roux-en-Y gastric bypass (190 patients) between 2007 and 2017. Before surgery, patients had a body mass index (BMI) of 46.9, were taking more than eight medications for various conditions, and 62.6 percent had Type 2 diabetes.

At nearly the three-year mark, patients had lost more than 60 percent of their excess weight, on average, and nearly half (45.8%) no longer had diabetes. At the 1-year follow-up, patients had cut the number of daily prescription medications they were taking by 3.1. The 90-day mortality rate was 0.3 percent and the major and minor complication rate was 5.6 percent and 16 percent, respectively, comparable to the rates of younger patients. A little more than 8.3 percent of patients had to be readmitted to the hospital after surgery.   

"Our study shows that both laparoscopic gastric bypass and sleeve gastrectomy can be as safe and as beneficial for older adults as it is for younger patients," said study co-author Anthony T. Petrick, MD, Director, Bariatrics and Minimally Invasive Surgery, Geisinger Health System.

Gastric bypass surgery involves cutting and stapling the stomach and rearranging or rerouting the small bowel. Sleeve gastrectomy, the most popular method of bariatric surgery, is performed by removing approximately 80 percent of the stomach and leaving a narrow gastric tube or "sleeve." In both procedures, because the stomach is made smaller, patients feel satisfied with less food. 

According to the National Center for Health Statistics, the obesity rate among older adults in 2015-2016 was 41 percent, slightly higher than the 39.3 percent rate among adults under 60, and the 39.8 percent rate among all adults, which is the highest rate ever in the U.S. About 18.5 percent of children in the U.S. had obesity. Hispanic adults had an obesity rate of 47 percent and Non-Hispanic black adults a rate of 46.8 percent.

Metabolic/bariatric surgery has been shown to be the most effective and long-lasting treatment for severe obesity and many related conditions and results in significant weight loss. The Agency for Healthcare Research and Quality (AHRQ) reported significant improvements in the safety of metabolic/bariatric surgery due in large part to improved laparoscopic techniques. The risk of death is about 0.1 percent and the overall likelihood of major complications is about 4 percent. According to a 2014 study from the Cleveland Clinic's Bariatric and Metabolic Institute, laparoscopic bariatric surgery has complication and mortality rates comparable to some of the safest and most commonly performed surgeries in the U.S., including gallbladder surgery, appendectomy and knee replacement.