OR22-08 Bariatric Surgery in People Over 70 years

Abstract Disclosure: P. Ortega: None. R. Yao: None. C. Izzi-Engbeaya: Novo Nordisk. Background: Due to increased life expectancy and the ongoing obesity pandemic, the prevalence of obesity in older people is high (e.g. >30% in the USA). Bariatric surgery is currently the most effective treatment for obesity. However, as efficacious multi-agonist medications are emerging, it is important to assess the risks and benefits of bariatric surgery in older people. Several studies have reported on the safety of bariatric surgery in people aged >60 yr, but relatively few studies have reported on the efficacy and safety of bariatric surgery in people aged ≥70 yr. Therefore, we conducted a systematic review and meta-analysis to compare post-bariatric surgery outcomes in people aged ≥70 yr and people aged <70 yr. Methods: Our systematic review was prospectively registered (PROSPERO ID: CRD42024499318). Searches were conducted using keywords in MEDLINE, Embase, Cochrane Central, Google Scholar and Scopus databases from inception to 10th January 2025. Two reviewers independently screened articles returned by the searches and selected articles that met the following criteria: written in English, randomised controlled, prospective or retrospective cohort studies that included patients aged ≥70 yr who underwent Roux-en-Y gastric bypass, one anastomosis gastric bypass, sleeve gastrectomy or laparoscopic adjustable gastric banding. Outcome measures included weight loss, co-morbidity remission/improvement, early and late complications and 30-day mortality. A random effects model was used to analyse pooled data in the meta-analysis. Results: Twelve articles were included in the meta-analysis with data available for 2,528 people aged ≥70 yr and 197,194 people aged <70 yr. The weighted mean±SD age (73.9±2.6 yr vs 44.3±11.2 yr, p<0.0001) was higher and preoperative weighted mean±SD BMI (42.4±8.0 kg/m2 vs 46.0±7.8 kg/m2, p<0.0001) was lower in the older group. Post-bariatric surgery BMI (mean difference in post-surgery BMI: 0.16 kg/m2 (95% CI -2.99-3.30), p = 0.92), likelihood of type 2 diabetes remission/improvement (≥70 yr vs <70 yr: OR 0.99 (0.70-1.42), p = 0.99) and likelihood of hypertension remission/improvement (OR 0.62 (0.32-1.21), p = 0.16) were comparable in both age groups. There was a higher likelihood of death within 30 days of surgery in the older group (OR 4.31 (1.53-12.11), p <0.01) as well as early complications (OR 1.55 (95% CI: 1.26–1.91; p < 0.0001). However, there was no difference in the risk of long-term complications (OR 0.88 (0.21-3.73), p = 0.86). Conclusion: Compared to younger people, bariatric surgery in septuagenarians is effective but is associated with higher risks of complications and death in the 30-day postoperative period. However, the risk of long-term complications is not increased. These data may be used to inform the choice of obesity treatment for older people. Presentation: Sunday, July 13, 2025