Coming to a facility near you: the bariatric surgery patient

Bariatric surgery is an increasingly popular intervention for morbid obesity, defined as a BMI>40. Its propensity to cause rapid weight loss can alleviate, if not resolve, obesity's comorbidities. Until recently, people older than 65 have been excluded by age in most established criteria because of a perception of great risk. Recent studies demonstrate that some elders, however, can benefit from bariatric surgery, and the surgery can be performed safely. Surgeons currently perform two types of procedures: restrictive and/or malabsorptive. Immediate risks of surgery are identical to other surgeries, but several additional risks, including an acute syndrome unique to bariatric surgery (APGARS) and rhabdomyolysis, have been identified in bariatric surgery patients. In the long term, four conditions may arise: symptomatic cholelithiasis, dumping syndrome, nutritional deficiencies, and panniculitis. All of these are preventable, and correctable, should they occur. As the high-risk population that undergoes bariatric surgery ages, consultant pharmacists should anticipate bariatric patients' life-long needs.