Weight Loss Surgery May Benefit Older Adults

Brenda Goodman

May 13, 2011

May 9, 2011 — Age does not appear to significantly increase the risks associated with having weight loss surgery, a new study shows.

The study analyzed data on more than 48,000 adults in a national registry who had open or laparoscopic bariatric surgery procedures between 2005 and 2009.

Over that period, the percentage of adults over age 65 who had surgery to loseweight more than doubled.

Researchers found that adults over 65 were not at significantly greater risk of experiencing a major adverse event or dying within a month of their surgeries compared to those in their 30s and 40s, though seniors were more likely to face longer hospital stays.

"If the patient is over age 65, and they're otherwise relatively healthy, I think this study gives surgeons an opportunity to tell the patients that they can undergo these operations with relatively similar outcomes compared to younger age populations," says study researcher Robert B. Dorman, MD, PhD, a general surgery resident at the University of Minnesota Medical School in Minneapolis.

The study was presented at Digestive Disease Week 2011 in Chicago.

"There's been a fairly dramatic increase nationally in offering bariatric surgery to older patients, and I think their study is important in that as we offer surgery to older patients, we need to make sure that outcomes are still safe and that offering surgery to this older population makes sense," says Thomas H. Magnuson, MD, director of the Johns Hopkins Obesity Surgery Service in Baltimore.

"Older patients definitely benefit from the operation oftentimes more in terms of quality of life. If you can have someone who is 72 years old lose 100 pounds, they can get better quality of life, such as, you know flying on an airplane with their grandkids or just getting around better to enjoy life," says Magnuson, who was not involved in the research.

Older patients, like younger patients, may also see improvements in medical conditions related to obesity, like type 2 diabetes, he says.

Weight Loss Surgery in Older Adults

For the study, researchers analyzed the records of 48,378 bariatric surgery patients that were collected by hospitals around the U.S. through the American College of Surgeons National Surgical Quality Improvement Program.

Patients included in the study had body mass indexes (BMIs) over 35. Each had undergone one of the following procedures: an open or laparoscopic gastric bypass, an open duodenal switch, laparoscopic gastric banding, or a vertical banded gastroplasty.

Seventy-two people died during the study. Eight were over age 65.

The risk of dying within 30 days of bariatric surgery was 0.12% for adults aged 35 to 49, 0.21% for those aged 50 to 64, and 0.4% for those over age 65.

After researchers took into account a host of factors thought to affect the outcome of weight loss surgery, including weight, gender, heart disease, diabetes, and kidney function, they found that risk of death for seniors was not statistically significant, meaning that the numbers didn't show a true difference.

Compared to middle-aged adults, older adults also did not appear to be at any increased risk of having major adverse events, like heart attacks, strokes, and serious infections, after their procedures.

Seniors did have longer hospital stays than younger adults, however, especially if they were over age 70 and the procedure involved opening the abdomen.

Prolonged hospital stays were considered to be anything over three days for a laparoscopic procedure and anything over six days after an open surgery.

Adults aged 65 to 69 had a 20% increased risk of a prolonged hospital stay after a laparoscopic procedure and an 80% increased risk of a prolonged hospital stay after an open procedure compared to those younger than 50.

For those over 70, there was no increased risk after a laparoscopic procedure, but a more than fourfold higher risk of a prolonged hospital stay after an open procedure.

"We tend to focus on younger patients, but obesity affects younger people as well as older people," Magnuson says.

"Studies like this point out that indeed the risk of surgery isn't any greater in carefully selected elder patients than younger patients," he tells WebMD.

For bariatric surgery patients of any age, things that did appear to predict the likelihood of a poor outcome included having type 2 diabetes, being a man, or having a BMI over 55, Dorman says.

Cost of Weight Loss Surgery

The procedures can be expensive.

According to the National Institute of Diabetes and Digestive and Kidney Diseases, bariatric surgery costs range from $20,000 to $25,000.

Insurance may cover the procedure if it's medically appropriate and could correct obesity-related illnesses.

"It's a big chunk of money up front to pay for the operation, but after three or four years, you actually see a return on investment and the surgery itself is cost-effective from a national health care point of view," Magnuson says.


Digestive Disease Week 2011 meeting, Chicago.

Robert B. Dorman, MD, PhD, general surgery resident, University of Minnesota Medical School, Minneapolis.

Thomas H. Magnuson, MD, director, Johns Hopkins Obesity Surgery Service, Baltimore.

News release, Digestive Disease Week 2011.

National Institute of Diabetes and Digestive and Kidney Diseases: "Bariatric Surgery for Severe Obesity."


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