About 26% of seniors 65 and older in U.S. are
obese, nearly 40% are
overweight, putting them at a higher risk for Type 2
diabetes,
high blood pressure and heart disease
We found seniors can benefit just as much as younger people from bariatric surgery without taking on additional risk.
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Morbidly obese seniors, age 65 and over, who had
laparoscopic gastric bypass surgery lost nearly 76 percent of their excess weight after two years and had low complication rates and short hospital stays comparable to younger surgical patients, according to a new study presented today at the 26th Annual Meeting of the American Society for
Metabolic &
Bariatric Surgery (
ASMBS).
?Bariatric surgery in the older population is underutilized because of a misperception that old age alone puts patients at higher risk for complications and mortality,? said Joseph Kuhn, MD, co-author and director of General Surgical Research at Baylor University Medical Center in Dallas, TX.
?We found seniors can benefit just as much as younger people from bariatric surgery without taking on additional risk.?
In one of the largest series of laparoscopic gastric bypass surgeries performed on elderly patients, researchers from Baylor University Medical Center analyzed a prospective database of 100 patients over age 65 and compared safety and outcomes to a younger population.
All patients had laparoscopic gastric bypass surgery between January 2005 and July 2008.
Prior to surgery, older patients demonstrated higher operative risk profiles compared to their younger counterparts in relation to -
- sleep apnea (45% vs. 34%)
- Type 2 diabetes (65% vs. 33%)
- hypertension (81% vs. 57%)
Older patients ranged in age from 65 to 77 with an average
BMI of 45, and younger patients ranged in age from 18 to 64 with an average BMI of 47.
Post-operative excess body weight loss (EWL) and complication rates were comparable in both groups.
At 12 and 24 months, both lost nearly the same amount of weight -- patients over age 65 showed 75.9 percent EWL after one year and 75.5 percent after two years; patients under 65 showed 77.8 percent EWL after one year and 79.2 percent after two years.
Neither group reported any deaths in the two-year follow-up period.
Post-operative complications were -
- low: bleeding (>65 1% v. < 65 1.3%)
- pulmonary infections (>65 3% v. <65 1.3%)
- cardiac (>65 2% vs. <65 0.36%)
- wound infections (>65 1% v. <65 1.7%)
Due to the age and overall health status of the older group, researchers noted it was particularly interesting to also find length of hospital stays (1.9 vs.1.3 days) and 30 day readmissions rates (6% vs. 7.4%) to be so comparable.
About 26 percent of people 65 and older in the U.S. are obese and another nearly 40 percent are overweight, putting them at a higher risk for
Type 2 diabetes, high blood pressure and heart disease. Since 1990, the prevalence of obesity has increased more than 50 percent in the elderly.
?The population is getting older and unfortunately more obese, so we will see a corresponding increase in the number of patients over 65 who are eligible for bariatric surgery and surgery needs to be an option for them,? said Christopher Willkomm, MD, study co-investigator from Baylor University Medical Center.
People who are morbidly obese are generally 100 or more pounds overweight, have a BMI of 40 or more, or a BMI of 35 or more with an obesity-related disease, such as Type 2 diabetes, heart disease or
sleep apnea.
According to the ASMBS, more than 15 million Americans are considered morbidly obese and in 2008 an estimated 220,000 people had some form of bariatric surgery. The most common methods of bariatric surgery are laparoscopic gastric bypass and laparoscopic
adjustable gastric banding (LAGB).
The ASMBS is the largest organization for bariatric surgeons in the world. It is a non-profit organization that works to advance the art and science of bariatric surgery and is committed to educating medical professionals and the lay public about bariatric surgery as an option for the treatment of morbid obesity, as well as the associated risks and benefits.
It encourages its members to investigate and discover new advances in bariatric surgery, while maintaining a steady exchange of experiences and ideas that may lead to improved surgical outcomes for morbidly obese patients. For more information about the ASMBS, visit
American Society for Metabolic and Bariatric Surgery
Source
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Body Mass Index BMI
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A statistical method of figuring out the degree of excess or insufficient weight based on one's height & weight. Though the controversial BMI does not actually measure the percentage of body fat, it is a useful tool to estimate a healthy body weight based on how tall a person is. |
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Morbid Obesity
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Bariatrics
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The branch of medicine that deals with the causes, prevention, and treatment of obesity. The term bariatrics was created around 1965, from the Greek root baro ("weight," as in barometer), suffix -iatr ("treatment," as in pediatrics), and suffix -ic ("pertaining to"). Besides the pharmacotherapy of obesity, it is concerned with obesity surgery. |
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Hypertension
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Also referred to as high blood pressure, HTH, HTN or HPN, hypertension is a medical condition in which the blood pressure is chronically elevated. In current usage, the word "hypertension" without a qualifier normally refers to arterial hypertension.
The Mayo Clinic specifies blood pressure is "normal if it's below 120/80". |
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Sleep Apnea
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A sleep disorder (a comorbidity often seen in obese patients) characterized by pauses in breathing during sleep. Each episode, called an apnea, lasts long enough so that one or more breaths are missed, and such episodes occur repeatedly throughout sleep. Sleep apnea is diagnosed with an overnight sleep test called a polysomnogram, or a "Sleep Study" which is often conducted by a pulmonologist.
A continuous positive airway pressure (CPAP) machine is used mainly by patients for the treatment of sleep apnea at home. |
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Roux-en-Y Gastric Bypass
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A type of gastric bypass procedure which combines restrictive and malabsorption techniques - meaning, it reduces the amount of food a patient can comfortably eat (restriction), and also reduces the amount of calories that can be digested in the small intestine (malabsorption). This combination of bariatric methods leads to greater weight loss and the roux-en-y procedure is seen as one of the best ways to treat clinically severe obesity.
See WLS Videos for animated surgery technique. |
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Laparoscopy
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Laparoscopic surgery, also called minimally invasive surgery is a modern surgical technique in which operations in the abdomen are performed through small incisions as compared to larger incisions needed in open surgical procedures. Laparoscopic surgery belongs to the broader field of endoscopy.
The key element in laparoscopic surgery is the use of a laparoscope: a telescopic rod lens system, that is usually connected to a video camera. Also attached is a fiber optic cable system connected to a 'cold' light source (halogen or xenon), to illuminate the operative field, inserted through a 5 mm or 10 mm Trocar to view the operative field. The abdomen is usually insufflated with carbon dioxide gas to create a working and viewing space.
The abdomen is essentially blown up like a balloon (insufflated), elevating the abdominal wall above the internal organs like a dome. The gas used is CO2, which is common to the human body and can be absorbed by tissue and removed by the respiratory system. |
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Obesity
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Obesity results from the excessive accumulation of fat that exceeds the body's skeletal and physical standards. Obesity has been defined as a weight more than 20% above what is considered normal according to standard age, height, and weight tables, or by a complex formula known as the body mass index. According to the National Institutes of Health (NIH), an increase in 20 percent or more above your ideal body weight is the point at which excess weight becomes a health risk.
CLICK HERE TO OPEN THE JOURNEY BMI CALCULATOR! |
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Diabetes Mellitus
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A disease that occurs when the body is not able to use blood glucose (sugar). Blood sugar levels are controlled by insulin, a hormone in the body that helps move glucose from the blood to muscles and other tissues. Diabetes occurs when the pancreas does not make enough insulin or the body does not respond to the insulin that is made. There are two main types of diabetes mellitus: Type 1 Diabetes and Type 2 Diabetes.
All forms of diabetes have been treatable since insulin became medically available in 1921, but there is no cure. |
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Gastric Banding Surgery
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The adjustable gastric banding is a restrictive surgical procedure during which a silicone band is placed around the stomach, creating a small pouch. The band includes a balloon that is filled with a nontoxic fluid, most commonly a saline solution; periodic adjustments are performed by a healthcare professional who accesses the balloon via a subcutaneous port.
Gastric band placement, unlike malabsorptive weight loss surgery (e.g. Roux-en-Y gastric bypass surgery, Biliopancreatic Diversion, and Duodenal Switch), does not cut or remove any part of the digestive system.
See WLS Videos for animated surgery technique. |
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Metabolism
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All of the processes that occur in the body that turn the food you eat into energy your body can use. Exercise, food, and environmental temperature influence metabolism. |
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Overweight
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It is defined as a Body Mass Index (BMI) of 25 to 29.9. Body weight comes from fat, muscle, bone, and body water.
It is important to remember that although BMI correlates with the amount of body fat, BMI does not directly measure body fat. As a result, some people, such as athletes, may have a BMI that identifies them as over their ideal body weight even though they do not have excess body fat.
CLICK HERE TO OPEN THE JOURNEY BMI CALCULATOR! |
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Type 2 Diabetes
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Previously known as "noninsulin-dependent diabetes mellitus" or "adult-onset diabetes" -- Type 2 diabetes is the most common form of diabetes mellitus. About 90 to 95 percent of people who have diabetes have type 2 diabetes.
People with type 2 diabetes produce insulin, but either do not make enough insulin or their bodies do not efficiently use the insulin they make. Most of the people who have this type of diabetes are overweight. Therefore, people with type 2 diabetes may be able to control their condition by losing weight through diet and exercise. They may also need to inject insulin or take medicine along with continuing to follow a healthy program of diet and exercise. Although type 2 diabetes commonly occurs in adults, an increasing number of children and adolescents who are overweight are also developing type 2 diabetes. |
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American Society for Metabolic and Bariatric Surgery
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The American Society for Metabolic and Bariatric Surgery (ASMBS) is the largest society of doctors specializing in bariatric surgery. The vision of the Society is to improve public health and well-being by lessening the burden of the disease of obesity and related diseases throughout the world.
Founded in 1983, the purpose of the society is to advance the art and science of bariatric surgery by continued encouragement of its members to carry out the following mission: - To improve the care and treatment of people with obesity and related diseases.
- To advance the science and understanding of metabolic surgery.
- To foster communication between health professional on obesity and related conditions.
- To be the recognized authority and resource on metabolic and bariatric surgery.
- To advocate for health care policy that ensures patient access to high quality prevention and treatment of obesity.
- To be a highly valued specialty society that serves the educational and professional needs of our diverse membership
More info regarding the ASMBS can be found online at http://www.asmbs.org/ |
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