With life expectancy getting better, there is a growing aging population worldwide. Associated with this is also the burden of chronic health issues, most of which are a result of a continued increase in obesity. In the US, cases of obesity in older patients (60 years and above) increased from 23.6 to 37 percent in the year 2010. This means today there are more than 22.5 million obese adults in the nation.
There has been a dramatic increase in offering weight loss surgery to older patients throughout the nation. This has been based on studies on older patients undergoing the procedure between 2005 and 2009 which showed that there are no increased risks associated with getting a weight loss surgery. Researchers found that adults who were over the age of 65 and relatively healthy were not at any significantly greater risk of experiencing a major surgical adverse effect. They can undergo the procedures with relatively similar results compared to the younger age population. The seniors are, however, more likely to face a longer hospital stay.
Obesity decreases the quality of your life as well as life expectancy. A bariatric surgery is the most efficient treatment for morbid obesity and its role in maintenance of weight loss is far superior to other medical therapies. Bariatric surgery, whichever procedure being used, results in more weight loss and improvement in other obesity associated issues when compared to non-surgical interventions.
Increased life expectancy does not mean an increase in healthy years as well. The obese elderly unfortunately faces more years of discomfort, chronic health issues and lack of mobility. Some of the common chronic diseases related to obesity include type 2 diabetes, heart disease, hypertension, metabolic syndrome, osteoarthritis, chronic renal failure, fatty liver disease and depression.
Older patients definitely benefit more in terms of the quality of their life. If a 75 year old patient can lose 100 pounds with a bariatric surgery, they will be able to move around better and enjoy life more, like being able to fly on an airplane to be with their grand kids. Just like younger patients, older patients may also see dramatic improvement in other medical conditions related to their obesity like cardiovascular diseases and type 2 diabetes. Where younger patients have a more complete resolution of other obesity related medical conditions, older patients reduce the number of medications they had to take earlier.
The physical outcomes of bariatric surgery have improved greatly over the past decade. Regardless of the age of a bariatric patient, the surgery leads to better mobility, reduced health concerns, reduction in pain, enhanced psychological functioning like improvement in self esteem and social interactions, and sexuality which offers a better quality of life. Even wheelchair bound older patients had regained full mobility in a few months post their surgery.
The records of more than 45,000 bariatric surgery patients was studied through the American College of Surgeons National Surgical Quality Improvement Program. The study concluded the risk of dying within 30 days of the surgery was 0.12 percent for those aged between 35 to 49, 0.21 percent for those between 50 to 64 and 0.4 percent for those above the age of 65. When all the other factors like weight, heart diseases, gender, diabetes were taken into consideration, it was found that the risk of death in seniors had no statistical significance.
It was also concluded from the study that older patients above the age of 70 did have a longer hospital stay than younger patients. This prolonged stay could be more than 3 days for a laparoscopic procedure and more than 6 days for an open surgery.
A pre-surgical psychological assessment is imperative to get positive outcomes in older patients undergoing bariatric surgery. Some of the concerns that remain with bariatric surgery and older patients are diet adherence, effects of nutritional deficiency and weight regain.