Older, Wiser, and Ready: Weight Loss Surgery Over Fifty
by Barbara Bietz
The decision to have any form of weight loss surgery is not an easy one. It involves information gathering, critical assessment, practical considerations, and a bit of soul-searching. For the over 50 crowd, the process can be even more challenging. Older patients have unique concerns, including increased surgical risks, insurance complications, family and social pressures, and the psychological impact of a major life change.
The Research
Responsible doctors will provide all patients with the pros and cons of any surgical procedure. But the patient must also be a pro-active consumer, this especially the case with senior patients. The research can be confusing, even contradictory, but access to such information is essential to making an informed decision.
UT Southwestern Medical Center published a report in December 2006 found that patients over 60 were at greater risk for complications and questioned if the benefits of surgery were worth the risk. Dr. Edward Livingston stated in Science Daily, ?Adverse outcomes increase with age, particularly after age 60 ?Beyond 65 Years of age, the adverse event rate exceeded 20 percent and mortality was 3.23 percent.?
A study conducted by Columbia University?s Center for Obesity Surgery reported no significant difference in the overall outcome when comparing patients over 60 with their younger counterparts. Another study conducted by the University of Florida also reported positive outcomes for patients 65 and older. Statistically, the rates of complications rates were similar to those of other surgeries for this age group. The benefits were also undeniable, according to the Associated Press, bariatric surgeon Dr. Michael Murr explained, ?We know it corrects the diabetes, it corrects the hypertension, it takes away sleep apnea, it fixes the heartburn reflux, it makes the knees and joints last longer.? For most doctors, decisions are made on a case-by-case basis. Many older individuals are good candidates for surgery, while for others the risk may to too great.
Kathie L. is 56. After her weight loss surgery she was able to undergo a hip replacement. She firmly believes without the weight loss, she would be confined to a wheelchair. Instead, she says ?I can now hike again, play on the floor with my grandchildren, even boogie board!? An unexpected side effect that was less desirable was the on set of menopause. Hormone related issues are not uncommon with weight fluctuations. Patients with concerns about hormone issues must inform their doctor.
During pre-op testing, Julia B., 54 was given a mammogram. Doctors discovered a malignant lump in her breast. Julia?s oncologist believes her breasts were exposed to increased amounts of estrogen, a direct result of her obesity. After surgery and radiation she was able to have weight loss surgery. Julia has lost 110 pounds and her doctor now believes her risk for a recurrence is very low.
Social-Family Issues
An older patient often has adult children who have input in the life-changing decision to have surgery. In some cases, an adult son or daughter may try to talk a parent out of surgery altogether. It is understandable for loved ones to have fears. Patricia R. from Michigan was 68 when she started her journey. Her adult son, who was reluctant, attended an orientation with her. Keeping family members in the loop is the key to creating a support system. The more information they have the less likely they are to undermine the process. It?s always a good idea to bring along a family member or friend to any appointments. They should be given the opportunity to express any concerns directly to the medical team, plus it gives the patient an extra set of ears. Family roles may shift during recovery. Older patients are often used to being the caregivers in the family and struggle with asking others for help. Open communication to deal with these issues will help the entire process.
Realistic Expectations
Although research varies, most suggest the seniors will loose weight more slowly than younger patients. This shouldn?t be a deterrent, but a factor to consider. Patricia R. sought surgical options for weight loss after years of unsuccessful dieting. She suffered from diabetes and high blood pressure. She said she ?could barely walk without being out of breath.? She worried the doctor would hesitate to operate, but after a complete medical and psychological evaluation she was approved. She showed her commitment to the process by losing 26 pounds before her RNY surgery. In just under a year, she had lost 88 pounds. Patricia is off her medication for diabetes and blood pressure. She exercises five days a week. ?To say I?m happy is an understatement. I would do this again in a heartbeat??
Surgery may not be a viable option for every senior. Kathleen O. from California is 72. She had been considering surgery for over two years. She knows first hand the difficulties that can arise before surgery. The first doctor she consulted was concerned about her age as well as significant scarring she had from previous surgeries. Lap band surgery was not an option at that time, and she was advised open surgery was risky. Kathleen put the idea on hold. With the initial surgeon now retired, Kathleen consulted a second surgeon. The new surgeon also had concerns about Kathleen?s age and due to her weight did not recommend lap band surgery as an option. Although RNY remained an option, Kathleen opted not to undergo such major surgery. For now, Kathleen is still seeking advice and investigating possible options.
Practical Considerations
Old habits die hard. The older we get, the truer this is. Older patients must be sure they are ready to give up old eating habits and coping mechanisms in favor of healthier choices. Since her surgery, Carol P., who was 58 at the time of her surgery, is about thirty pounds from her goal weight. She exercises regularly and has a ?new lease on life.? Still, she says, ?The implications for older women involve some problems keeping up the social life and leaving behind the comfort of food. At our age we have established such patterns that it is a very tough change. Carol?s insights underscore the reality that weight loss surgery is not the end of the journey ? it is the beginning.
Older patients have much to gain from a healthier lifestyle, but the sacrifice can be great. Finances must always be considered, but especially for seniors on a fixed income. Issues of insurance and Medicare vary from state to state and patients should never make assumptions about coverage. To be an informed consumer, patients must do the homework; read research online, call the insurance provider, and make a list of questions before meeting with doctors. All potential candidates for surgery should join a support group, explore ObesityHelp.com (especially the Over 55 Forum), and enlist the help of family and friends ? the more they know, the more support they can offer.
In the final analysis, the decision to have weight loss surgery must be made by the patient and his or her medical team. Older patients can have great success with weight loss surgery, especially if they start the journey with knowledge, realistic expectations, the ability to access information, and the support of family and friends.
To visit the Over 50?s forum click here. http://www.obesityhelp.com/forums/over_50/
