Obesity is a growing public health problem for Americans of all ages and races. Amongst seniors 65 and up, the prevalence of obesity is increasing. Bariatric procedures are surgical interventions that aim to manage obesity and promote weight loss when other weight loss interventions fail. Dr. Orestis Panagiotou, an Assistant Professor of Health Services, Policy and Practice and his colleagues assessed the safety and efficacy of bariatric procedures amongst the Medicare-eligible population. In this systematic review of 16 studies, they found that there was a low to moderate strength of evidence that supports the effects of bariatric surgery on non-weight loss outcomes in the Medicare-eligible population.
The authors found that compared to having no surgery or other weight loss treatments, studies showed that weight loss was greater when bariatric surgery was performed. Bariatric surgery also resulted in a lower overall mortality of 30 days, a lower risk of cardiovascular disease, as well as improvements in respiratory, musculoskeletal, metabolic, and renal functions.
A few studies that looked at cardiovascular outcomes found that patients who undergo bariatric surgery have a lower chance of myocardial infraction than patients who underwent gastrointestinal and orthopedic surgery. They also had lower rates of coronary artery disease compared to patients who didn’t undergo surgery. Two studies reported that patients who underwent bariatric surgery had a lower risk of cardiovascular-related mortality than patients who did not. Another study found that amongst Medicare recipients, 6 and 18 months post bariatric surgery; there were improvements in sleep apnea. Two studies compared bariatric surgery to no surgery and found that at 1 and 1.5 years post-surgery, rates of diabetes were lower for patients who underwent surgery compared to those who did not.
The authors conclude that while this review shows that there is a link between bariatric surgery and weight loss, as well as other positive health outcomes, for those who are eligible for Medicare (i.e.: 65 and up); more well-designed studies will be needed to identify which of many bariatric procedures is the most effective and for which patients.