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Weight Loss Surgery Safe for Seniors

Older Patients Can Benefit From Gastric Bypass Surgery, Researchers Say
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WebMD Health News

Feb. 22, 2005 -- Gastric bypass surgery isn't just for the young, says a study in February's Archives of Surgery.

The weight loss procedure has soared in popularity. Gastric bypass was performed 10 times as often in 2001 as in 1987.

In the procedure, surgeons bypass the stomach by closing off a section of the stomach, leaving a small pouch that accommodates a few ounces of food. That drastically reduces the amount of food that people can eat. The pouch is attached to part of the small intestine so that food bypasses the rest of the stomach to reduce absorption of calories and nutrients.

Obesity Boom Drives Demand

Interest in gastric bypass has grown along with America's waistline. Nearly 20% of the U.S. population was obese in 2001, compared to 12% 10 years earlier, say James Swain, MD, and colleagues from the Mayo Clinic in Scottsdale, Ariz.

Dramatic weight loss stories from celebrities and other obese people who've undergone the surgery have also fueled interest. Less invasive procedures have also become available that avoid the large incision normally made during the bypass procedure and cut down on in-hospital recovery time.

But some headlines have noted the dangers that can occur. Last October, two studies showed that the short-term dangers may be higher than previously thought, although the long-term benefits of shedding extra pounds could make the surgery worthwhile.

Does Age Make a Difference in Gastric Bypass Surgery?

The risks apply to everyone. Weight loss surgery isn't done casually; it's a last resort for overweight or obese individuals who have tried other methods and have been unsuccessful. But age alone doesn't rule out the procedure, say James Swain, MD, and colleagues from the Mayo Clinic in Scottsdale, Ariz.

Provided that older patients are healthy enough to have the surgery, "patients of advanced age can safely undergo [gastric bypass]," write the researchers.

That goes against some providers' policies, they say. Since so many people are obese and Americans are living longer than ever before, Swain's team took a fresh look at gastric bypass surgery and age.

Gauging Health Before Surgery

Study participants were 110 people younger than 60 years old and 20 people who were older than 60 years old. All were morbidly obese and had other medical conditions related to obesity.

The younger patients were about 45 years old on average. The older patients had an average age of 65.

Before surgery, both groups weighed a little over 300 pounds (305 pounds for the older group and 301 pounds for the younger group). The younger group's body mass index (BMI) was higher (48, compared with 42 for the older group).

Which Age Group Fared Better?

Judging by the scale, the younger patients did a bit better. They lost more weight and had a greater drop in BMI.

The younger patients lost nearly 97 pounds, lowering their BMI by 15 points. The older patients shed about 86 pounds and dropped almost 13 BMI points.

The younger patients also unloaded an average of 2.3 obesity-related medical problems such as sleep apnea. While the older patients also improved their health, they dropped just under two health problems after the weight loss surgery.

But the older patients fared better in another area. After the surgery, they were able to reduce the number of medications they normally took. At the last follow-up, they took an average of 2.7 medications, down from nearly five. The younger patients also cut back to barely one prescription per person after surgery. That's a significant decrease, but it's less than what their elders achieved.

Both groups had similar rates of complications and stayed in the hospital for roughly the same number of days (about three days for the older patients and 2.5 days for the younger ones).

"Patients older than 60 years can be considered good candidates for obesity surgery," say the researchers. They plan longer follow-up to track survival and health cost savings.

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