New research from Brigham Young University finds that patients who undergo gastric bypass surgery after the age of 35 see a major improvement in long-term survival.
Surprisingly, even obese people well into their 70s can experience significant life-sustaining benefits by opting for the surgery, according to the study published today in JAMA Surgery.
"It challenges the assumption that people are too old for surgery and wouldn't benefit from it," said lead author Lance Davidson, a professor of exercise science at BYU. "Surgery seems to be tempering mortality risk dramatically with increasing age."
Gastric bypass surgery is a procedure wherein a pouch is created out of small portion of the stomach and is attached directly to the small intestine, bypassing a large part of the stomach. People who undergo the surgery generally lose a significant amount of weight because they become full on less food.
For the study, Davidson and his colleagues analyzed the mortality data of 15,850 severely obese individuals, half of which had elected to undergo gastric bypass surgery. The researchers analyzed the mortality benefit of the procedure across four age groups: under 35, 35-44, 45-54 and 55 to 74.
They found gastric bypass surgery was associated with improved long-term survival for patients in the 35-44, 45-54 and 55-74 age groups. Additionally, deaths from cardiovascular disease and cancer were significantly lower for those undergoing gastric bypass surgery compared with those not undergoing surgery.
"We expected that having the surgery at older ages might reduce the effectiveness of the operation because of the challenges of long-standing diseases," Davidson said. "But severely obese people aged 55 through 74 saw an even higher mortality benefit."
Specifically, the study found a 66 percent reduction in mortality for the oldest age group who have had the procedure compared to their obese counterparts who have not.
However, the study did find that primarily women who undergo the procedure prior to age 35 seemed to be at a higher risk of death from external causes (injuries, car accidents, poisonings, murder). Davidson said this finding still needs additional research and longer follow-up to establish a more definitive assessment of risks for this younger group. That said, healthcare providers should take note.
"The recommendation for clinicians would be to make sure to monitor and support those at higher risk for external mortality, particularly those of younger ages," Davidson said.
Researchers are quick to point out that the results do not imply that a severely obese person should wait until an older age to undergo surgery.