Obesity Abstracts

Introduction: Obesity is common (prevalence 30%) in older adults (≥65 years). Bariatric surgery (BS) is the most effective intervention resulting in sustained weight loss and cardiovascular and metabolic benefits. However, the outcomes of BS in older patients are unknown.

Methods: A retrospective study utilising the bariatric database from a single UK NHS BS centre. We identified all older patients, aged ≥65 years old at surgery, who had BS between 2003 and 2013 and all were matched to 2 ‘typical’ aged controls (38 – 53 years old, the age IQR for BS patients at our centre) for surgical procedure, gender, referral body mass index (BMI) and diabetes status. Data were obtained from both local and GP records. Survival was compared between cases and matched controls using Kaplan-Meier estimators and the log rank test up to 5-years post-operatively.

Results: The mean age (S.D.) for cases (n=41) and controls (n=82) were 67 (2.3) and 46 years (5.1), respectively. Mean BMI was 47 kg/m² (7.2), 34% were men and 59% had Type 2 diabetes. There was 0% mortality in both cases and controls at 30-days post-operative. Over 5-years post-operative follow-up; there was 9.8% (n=4) mortality in older adults (9.8%) 1.2% mortality (n=1) in controls (P=0.03). No deaths were due to surgical complication. At 5-years post-operative, BMI reduction in older adults (7.2±6.1 kg/m²) was significantly less than younger controls (11.6±8.6 kg/m²) (t(72)=−2.218, P=0.030). Meanwhile there was no significant difference in change in HbA1c among patients with Type 2 Diabetes (P=0.516).

Conclusion: In older adults, BS was not associated with increased 30-day mortality or surgical-related mortality up to 5 years post-surgery. BS resulted in clinically meaningful BMI reductions in older patients at 5 years post-surgery. However, BMI reductions were significantly greater in younger patients at 5 years post-surgery. The impact of surgery on glycaemic control was similar across older and younger adults with Type 2 diabetes. BS is a valid option of treatment in older patients with obesity, future studies need to examine the impact of surgery on functionality and quality of life in this patient group.