Metabolic and bariatric surgery can offer major benefits for adults in their 70s, new evidence shows

New research is shedding light on the benefits of metabolic and bariatric surgery for adults in their 70s, challenging long-held assumptions that age should limit access to treatment.

As obesity rates rise in ageing populations, improving health and quality of life for older adults has become increasingly important. Although surgery was once considered suitable only for younger individuals, current guidance now recognises that chronological age alone should not determine eligibility.

A new study published in The Lancet Healthy Longevity examined outcomes for people in England aged 69 and over who underwent metabolic and bariatric surgery. After matching people for key characteristics, the researchers found a striking 75 per cent reduction in mortality among those who had surgery compared with those who did not. This suggests that even later in life, surgery can offer a meaningful survival advantage. While the findings are encouraging, the authors note the potential for bias, as individuals who are well enough for surgery may already be healthier than those who are not.

The risks associated with surgery were considered acceptable, with nine per cent experiencing complications and 30-day mortality at two per cent. Other studies show older adults may face higher risks than younger people, so careful preparation remains essential. Preoperative optimisation, including weight reduction and comprehensive assessment of frailty, cognition and functional ability, can help improve outcomes.

Weight-loss medications also have a role, though older adults may be more susceptible to side effects. Newer agents appear better tolerated and may be used as an alternative or a bridge to surgery for those who are not immediately suitable.

Overall, the emerging evidence is clear many septuagenarians can benefit significantly from metabolic and bariatric surgery when individually assessed. Age should not be an automatic barrier, and treatment decisions should reflect each person’s health needs, priorities, and goals.