Current National Institutes of Health guidelines caution surgeons not to operate on obese patients over age 60. Surgeons in the Bronx, NY have been performing bariatric surgery on such patients for years, and say they have had good results.
The US is getting older and fatter. Diets have not helped reverse the obesity trend. Many of these older patients could be helped by bariatric surgery, but the comorbidities that often come with obesity can be seen as a barrier. Guidelines drawn up by the National Institutes of Health currently put the recommended cut-off age for bariatric surgery at 59.
Writing in the journal Obesity Surgery, Mujjahid Abbas and colleagues at Montefiore Medical Center and Albert Einstein College of Medicine (both in the Bronx, NY) say they believe such surgery in patients over 60 is feasible and usually improves their health. Montefiore “is one of the few that will performs bariatric surgery on patients above the age of 59,” the authors said.
“Bariatric surgery is safe and effective for patients older than 60 years of age and can be performed with a low morbidity and mortality resulting in weight loss and improvement in comorbidities,” he wrote in the article, published in the December edition of the journal.
The team looked at their institution’s patients’ medical records from January 2009 through October 2013. They selected patients over 60 who had bariatric surgery.
They compared data on those patients to a group of patients 22 to 59 years old.
Overall 83 patients fit their study criteria. Of those 30 had laparoscopic sleeve gastrectomy (LSG) and 53 had laparoscopic Roux-en-Y gastric bypass.
The average patient age was 63.4 years, and their average weight was about 270 lbs.
Among their cormorbid conditions were hypertension, diabetes, hyperlipidemia, obstructive sleep apnea and asthma.
After surgery, patients’ results were similar to those for the younger comparison group, the researchers said.
They had about the same estimated weight loss—about 65% of their original weight at 12 months post-surgery.
Their rates of complications were also similar. There were no deaths during surgery in the older group. In 31% of patients with diabetes in the older group, the illness went away. It improved in 62%. Of patients with hypertension, 86.7% no longer had it.
The importance of the study, the authors said, is that obesity has risen dramatically in the last few decades. There are an estimated 21 million obese people over age 60 in the US, a number expected to increase.
“The effects of obesity on health care costs are multifaceted and expectedly enormous in magnitude in light of a risking number of individuals older than 65 living in nursing homes,” they wrote.
One potential drawback in operating on older people could be loss of bone density as the surgery can interfere with absorption of Vitamin D and calcium. The authors said they were not convinced studies that found that result were relevant because they were done on younger people.
“Bariatric surgery in the older population can be a safe option,” the team concluded.