Q. I’m 69 years old and I’m considering surgery for obesity. Am I too old for this?
There is no upper age limit for this type of surgery. However, the procedure is riskier for anyone older than 65.
Obesity surgery — also known as bariatric surgery — limits your food intake. Some operations also restrict the amount of food you can digest. It is designed for men who are at least 100 pounds overweight and women at least 80 pounds overweight.
Surgery is an extreme measure for people who can’t lose weight through normal diet and exercise. Recent studies suggest that this kind of surgery may reduce death rates for the obese.
Now for some anatomy.
When we swallow, food moves down the esophagus to the stomach, where a strong acid continues the digestive process. The contents of the stomach contents move to the duodenum, the first segment of the small intestine. In the duodenum, bile and pancreatic juice speed digestion.
The jejunum and ileum, the remaining two segments of the nearly 20 feet of small intestine, complete the absorption of almost all calories and nutrients. The food particles that cannot be digested in the small intestine are stored in the large intestine until eliminated.
There are four kinds of obesity surgery that are used in the USA:
Roux-en-Y Gastric Bypass reduces food intake and absorption. This is the most common obesity surgery. In gastric bypass surgery, the stomach is divided into two parts. Food is rerouted from the smaller upper part of the stomach, called the pouch, to the small intestine. Food no longer travels through the remaining part of the stomach .
Adjustable Gastric Band limits food intake with a band around the top of the stomach. The size of the restriction can be adjusted with a circular balloon inside the band.
Duodenal Switch removes a large portion of the stomach, reroutes food away from much of the small intestine and also reroutes digestive juices.
Vertical Sleeve Gastrectomy involves removing a large portion of the stomach and creating a tubular gastric sleeve. The smaller stomach sleeve remains connected to a very short segment of the duodenum, which is then directly connected to a lower part of the small intestine. This operation leaves a small portion of the duodenum available for food and the absorption of some vitamins and minerals.
Obesity surgery may be done through a traditional abdominal opening or by laparoscopy, which requires only a half-inch incision. The surgeon uses the small incision to insert instruments and a camera that transmits images to a television. Most bariatric surgery today is done laparoscopically.
Many people who have bariatric surgery lose weight quickly. If you follow diet and exercise recommendations, you can keep most of the weight off. The surgery has risks and complications including infections, hernias and blood clots.
One study of bariatric surgery showed that patients lost an average of 61 percent of their excess weight. In addition to weight loss, these patients earned the health benefits that go with it. More than 7 out of 10 patients with diabetes, elevated cholesterol and high blood pressure improved so much that they needed less or no treatment for their conditions.