Surgery for obesity & metabolic diseases
Making state of the art surgery affordable
Because of the fact that longevity has increased in recent decades, as has obesity, it is increasingly common to see older patients that suffer obesity.
As bariatric surgery has gained traction due to its safety and effectiveness, both in achieving significant weight loss and in improving chronic conditions, we are increasingly getting this question asked:
Is it possible to do the gastric sleeve to an older adult?
It has been approximately only 20 years since bariatric surgery is considered a serious branch of surgery and is fully established as an effective treatment for obesity. So in those days, it was considered that the age of 60 was a prudent limit to consider them as candidates.
However, this was rather an arbitrary number, where the risks were thought to increase and outweigh the benefits. However, with advances in anesthesia techniques, medications, and refinement of the laparoscopic surgical technique for obesity surgery, this age limit has increased to the point where surgery is considered viable in well-selected cases aged up to 70 years or more!
The short answer to the question of Is it possible to perform weight loss surgery on an older adult? is: Yes.
As in the case of gastric sleeve for adolescents, it is important to make a good selection of the patient. In other words, not only because the patient is a candidate from the point of view of his body mass index, is eager and wants obesity surgery, it will be enough to consider him/her suitable for it.
It is very important to take comorbidities into consideration and see how much they have affected organ function over the years.
A complete preoperative assessment by a multidisciplinary team is necessary in all cases, however, in elderly patients, it is likely that there is a need to delve a little deeper if any alteration is detected in the initial assessment.
We specifically refer to the likely need for tests such as cardiovascular stress tests, pulmonary function tests, carotid and/or cardiac ultrasound.
There is a widespread idea that bariatric surgery is dangerous and causes even more fear when it comes to patients over 60 years of age.
But unlike what many people think, the belief that being older and diabetic for example, is a contraindication for undergoing gastric sleeve or gastric bypass surgery and that is not true. It is a completely wrong concept since it is quite the opposite: there is no better candidate for a bariatric procedure than someone who, in addition to suffering from obesity, has a metabolic or chronic-degenerative disease such as diabetes mellitus, high blood pressure, among many others.
What we must be sure of in these cases is that these diseases have not already caused irreversible damage that puts their integrity at risk, either during or after surgery. Therefore, a thorough preoperative evaluation is very important.
Despite the aforementioned, we usually tell our potential patients that there really is no better medicine than prevention, that is:
That if they are over 60 years old and are considering obesity surgery but are not sure if it is a good option since they do not suffer from any additional disease, this is the best time to take action on the matter and thus through bariatric surgery prevent the development of these diseases, especially if there is a genetic load in the family that is conducive to suffering from them.
Finally, if you are considering gastric sleeve surgery, bypass or any other weight loss procedure, we want to tell you that it is proven not only by experience with our patients, but also by studies and statistics worldwide that the safety of bariatric surgery in adults older than 60 years is equivalent to that seen in younger people.
This same study also mentions that there were no differences between the rate of complications between young and elderly patients, in addition to the fact that it was independent of the bariatric procedure performed. In other words, both gastric sleeve and gastric bypass, the main bariatric procedures performed worldwide, were considered equally safe.
In our practice we frequently hear comments from older patients that their main regret regarding bariatric surgery is not having performed it decades earlier!
Source:
https://pubmed.ncbi.nlm.nih.gov/26508845/
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