Weight Loss Surgery May Help Obese Seniors

Three new studies show that weight loss surgery may help obese older adults.

The CDC says that 69 percent of Americans aged 65 and older were overweight or obese in 1999-2002.

As more people live longer, the number of obese seniors is likely to grow, say researchers Ricardo Cohen, MD, and Amna Daud, MD, MPH.

Cohen and Daud worked on two of the new studies. Their results were also presented in Orlando, Fla., at the American Society for Bariatric Surgery's annual meeting.

Researchers' Comments

Cohen and Daud spoke with WebMD about weight loss surgery for older obese adults.

"We can achieve excellent results with very low [illness] and [death] rates in these kinds of patients," says Cohen. He also says the surgery can "cure them of most problems that can occur due to obesity."

Daud says her findings were "very preliminary" and included a small number of people. From what she's seen so far, Daud says some seniors fared better after surgery than younger patients.

Read WebMD's "Study Weighs the Risks of Gastric Bypass"

Gastric Bypass Study

Cohen and colleagues studied 108 obese people aged 60 and older whogot gastric bypass surgery.

The operation reduces the stomach's size and bypasses part of the small intestine where food is absorbed.

Before the surgery, 73 patients had high blood pressure, 66 had type 2 diabetes, 19 had gastroesophageal reflux disease (GERD), and 12 had sleep apnea -- all obesity-related disorders.

Two years later, 46 patients were "cured" of high blood pressure and 51 of diabetes; all GERD and sleep apnea cases were "cured," say Cohen and colleagues.

They work at the Hospital Sao Camilo in Sao Paolo, Brazil.

'Good' Results, Obedient Patients

Patients had "good" long-term weight loss and obeyed doctors' orders, says Cohen.

"It's interesting to know that those elderly patients are more compliant," he tells WebMD.

"They don't miss follow-ups. They exercise. They're more mature in their decisions. So we can achieve good results in that kind of population," says Cohen.

Daud says older patients in her study were also more compliant than younger ones.

Read WebMD's "Weight Loss Surgery Safe for Seniors"

Gastric Banding Study

Daud's study included 45 people aged 60 and older. They got gastric bypass or adjustable gastric banding surgery.

In gastric banding surgery, an inflatable band is placed around the upper part of the stomach, creating a small pouch, which helps restrict the amount of food eaten.

For comparison, the researchers also followed more than a thousand younger people who got the same operations.

A year after surgery, the older people who got gastric banding were "actually doing better" than younger patients who had the same procedure, says Daud.

There was no difference in results for younger and older gastric bypass patients, the researchers report.

It will be interesting to see the results after two years, says Daud. She is a clinical research coordinator at New York's Columbia Presbyterian Hospital.

'Safe and Beneficial'

A third study, done at the Cleveland Clinic Florida, included 31 people aged 65 and older who got gastric banding. Over the next year they had reductions in blood pressure, high cholesterol, diabetes, and sleep apnea, among other conditions.

"Laparoscopic gastric banding is a safe and beneficial procedure in the elderly population," say the researchers, who included Flavia Soto, MD.

Read WebMD's "Weight Loss Surgery May Cure Health Woes"

Surgery Not Without Risks

Weight loss surgery has risks, just like any operation using general anesthesia, says Daud. The risks may be "a little higher" for older patients, she says.

It's important to make sure that diabetes is under control before surgery, says Daud.

Cohen says gastric bypass surgery is the "gold standard." He says gastric banding may have more complications, which can include banding slippage and erosion.

However, Daud says her group had no complications, even minor ones, with gastric banding. The surgeon's experience can be a factor, she says.

She and her colleagues say that based on their results, gastric banding might be the better option for older obese adults.

Cohen and Daud agree that weight loss is slower with gastric banding than with gastric bypass.

Diet, Exercise Still Count

Cohen and Daud both say weight loss surgery can be safe for older obese adults. But they also say that surgery is not the only answer.

Exercise and healthy eating are also important, as at any age, they say.

Of course, it's possible to lose weight without surgery. But it's often difficult for older people, say Cohen and Daud.

"I think support is really important, as well," says Daud. Support groups for patients may be helpful, since families may not understand the issues, she says.

Read WebMD's "Weight Loss Surgery: Is It For You?"

By Miranda Hitti, reviewed by Brunilda Nazario, MD

SOURCES: American Society for Bariatric Surgery's 22nd Annual Meeting, Orlando, Fla., June 26-July 1, 2005. News release, CDC. News release, American Society for Bariatric Surgery.