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Weight-Loss Surgery for Seniors — Is It Advised or Is It Too Late?

By Kent Sasse December 30, 2021 Health and Fitness

At one point, weight-loss surgery was considered almost a cosmetic procedure despite its origins aiming to resolve or correct diabetes. For decades, health insurance plans wouldn’t cover weight-loss surgery, and few medical doctors or medical societies recommended it. But times have certainly changed.

Correcting Metabolism

Today, weight-loss surgery goes by the more apropos name metabolic surgery because it targets specific tissues that change the hormones regulating metabolism. These hormones establish the setpoint for body weight, blood sugar regulation, fat storage, and liver function. It turns out that the most critical of these hormones come from tissues in the stomach and intestine.

In a recent large study by A.G. Doumouras, entitled Association Between Bariatric Surgery and All-Cause Mortality: A Population-Based Matched Cohort Study in a Universal Health Care System, the authors found:

“Bariatric surgery was associated with substantially lower all-cause, cardiovascular, and cancer mortality. The lowered observed mortality of surgery was significant across most subgroups. The largest absolute effects were for men and patients aged 55 years or older.”

While in the past, strategies focused on restricting calorie intake through a variety of stapling and encircling devices like bands and balloons, the more successful strategies involved changing the gastrointestinal tissues and the flow of nutrients.

A Routine Procedure

Around 15 years ago, the study of critical hormones that regulate that body weight setpoint and blood sugar pinpointed them to the outer stomach. This led to adoption of a simpler and safer procedure that trims off a portion of the outer stomach tissue through four tiny incisions in a 45-minute procedure. 

The procedure has become more routine and safer than an appendectomy, but its long-term health benefits are profound. Among them are large reductions in heart disease, stroke, diabetes, and even cancer.

Because these findings have become so well studied and widespread – including 30-year outcomes from entire nations and states – the medical societies and specialists who were once skeptics have provided strong endorsements for seniors.

In Obesity and Cardiovascular Disease: A Scientific Statement from the American Heart Association, the authors write “reduced CAD risk has been demonstrated in prospective studies comparing patients undergoing bariatric surgery with nonsurgical patients with obesity, with the Swedish Obesity Study finding significantly lower rates of fatal and nonfatal cardiovascular events in those undergoing bariatric surgery.”

Who Is Weight-Loss Surgery Suitable for?

The American Heart Association, American Diabetes Association, and countless other specialty health organizations now recommend metabolic surgery for individuals with excess weight, especially when there are concomitant health conditions such as high blood pressure, type two diabetes, and obstructive sleep apnea.

Seniors experience reductions of risk moving forward after the procedure, with reductions of stroke, heart attack, and mortality risk chief among them. Life expectancy increases as a result.

In short, what was once a strange quasi-cosmetic surgery is now a well proven and very safe risk reduction tool for seniors with excess weight, high blood pressure or diabetes.

Are you at a high risk for diabetes or cardiovascular conditions? What types of treatments or preventions have you tried? What do you know about weight-loss surgery, aka bariatric/metabolic surgery? What else would you like to know?

Let's Have a Conversation!

The Author

Dr. Kent Sasse, an Alpha Omega Alpha top medical school graduate of UCSF, earned fellowship at the prestigious Lahey Clinic in Boston and published research on pelvic floor therapy and metabolic surgery. He founded and directs The Continence Center and the nationally accredited Metabolic and Bariatric Surgery program in Reno, Nevada. His most recent book is Outpatient Weight-Loss Surgery.

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