One-year outcomes of bariatric surgery in older adults: a case-matched analysis based on the Tehran Obesity Treatment Study

Abstract

Knowledge is limited about the efficacy, safety, and long-term outcomes of bariatric surgery in older adult patients with obesity. Fifty-six patients aged ≥ 60years who underwent bariatric surgery, as either sleeve gastrectomy or gastric bypass, were matched for sex, baseline body mass index (BMI) and surgery type, with 112 younger controls, aged 18-60years. We compared complications, weight loss, resolution of co-morbidities, and changes in body composition status (fat mass [FM], fat-free mass [FFM], lean mass [LM] and percentage of fat mass [FM%]) 12months postoperatively between the groups. Complications were similar in the two groups. Diabetes mellitus (DM) and dyslipidemia showed similar remission and improvement rates postoperatively in the two groups. Remission from hypertension (HTN) was higher in the control group, but improvement rates were similar. Changes from baseline to 12months postoperatively in weight, BMI, excess weight loss (EWL%), total weight loss (TWL%), FFM, and LM were greater in the control group than in the older-age group. Changes in FM and FM% were similar in the two groups. Bariatric surgery is a safe intervention for the management of obesity and obesity-related co-morbidities in older adults, with similar surgery-risk and complication rates to those of younger adults. Reduction in FM and FM% was equal in two groups and the concern about greater LM loss in older adults seems unfounded.