While weight-loss surgeries are not usually performed in people above the age of 65, a new study shows that these procedures can lead to successful weight loss and better diabetes control in older adults. The study, presented at the Society for Endocrinology annual conference in Brighton, UK, indicates that elderly patients treated with bariatric surgery (gastric bypass or gastric sleeve) can recover well and have a reduced risk of obesity-related complications, including heart disease and diabetes.
Obesity is a growing, global health epidemic that needs more effective intervention strategies to avoid debilitating complications including heart disease, kidney failure and type 2 diabetes. Weight loss surgery is rarely recommended for obese adults over 65, due to perceived increased risk, yet the health and quality of life in this patient group can be severely affected for many years. As a consequence, very little data are available on the potential benefits or risks of weight loss surgery in elderly patients.
Nader Lessan, MBBS, MD, FRCP, and study co-author Saradalekshmi Radha, both from the Imperial College London Diabetes Centre in Abu Dhabi in the UAE, assessed the results of 22 patients who had attended their medical centre and who had undergone weight loss surgery after the age of 65. Two years after weight-loss surgery, the patients had, on average, lost 24% of their original body weight. In addition, of the 11 patients who had been on insulin to control their type 2 diabetes, four no longer needed it, while for others, the total insulin dose required had significantly decreased. The only adverse effects reported during the two year period were iron and vitamin D deficiencies, which happen in younger patients, too.
“Although based on a small number of patients, our data suggest that successful weight loss and improved diabetes control can be safely achieved with surgery in older patients, which could have real benefits for their longevity and quality of life,” Lessan says.
As this study was retrospective using the limited data available, the next step would be to conduct a prospective, observational study among the older population. Then we could more effectively compare outcomes of surgery with other interventions such as medication or lifestyle modifications.
“Management of obesity and diabetes in old age is challenging,” Lessan says. “There is a lot of skepticism around conducting weight-loss surgery in patients over 65. Our study suggests these procedures could be considered in older adults as an effective intervention to aid weight loss and associated complications.”
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