Metabolic - Bariatric Surgery in Elderly Patients - Safety and Effectiveness in a Single-Center Cohort

Overweight and obesity have been steadily increasing worldwide. Metabolic/bariatric surgery (MBS) is the most effective treatment for obesity and its associated medical conditions. Obesity complications increase with age, however, older patients face a higher perioperative risk necessitating a clear risk-benefit balance. This study evaluated weight-loss outcomes, remission of associated medical conditions, and complications in patients aged ≥ 65 years undergoing MBS.

This retrospective analysis included patients aged ≥ 65 years who underwent MBS at the Medical University of Vienna between 2008 and 2025. Weight and associated medical complications were assessed at baseline and at 1, 2, and 5 years postoperatively. Early (< 30 days) and late complications up to 5 years were recorded.

In total, 111 patients were included. Baseline weight was 125.8 ± 22.3 kg and BMI 45.2 ± 7.4 kg/[Formula: see text]. At 5 years, mean BMI decreased to 27.5 ± 6.2 kg/[Formula: see text] corresponding to a total weight loss of 37.3 ± 14.7%. The prevalence of type II diabetes decreased from 54.1% to 22.9% and arterial hypertension from 87.4% to 56.2%. Early and late complications each occurred in 7.2%.

MBS achieves substantial long-term weight reduction and remission of associated medical conditions. Complication rates are relatively high, underscoring careful patient selection is essential. Larger prospective studies focusing on elderly populations are warranted.

MBS in elderly patients is effective in terms of weight loss and remission of associated medical complications. - MBS in elderly patients was associated with a relatively high complication rate. - Deaths within the study period were not associated with the MBS procedure.