Metabolic - Bariatric Surgery in Elderly Patients – Safety and Effectiveness in a Single-Center Cohort

Introduction Overweight and obesity have been steadily increasing worldwide. Metabolic/bariatric surgery (MBS) is the most effective treatment for obesity and its associated medical conditions. Obesity complications increase with age, however, older patients face a higher perioperative risk necessitating a clear risk-benefit balance. This study evaluated weight-loss outcomes, remission of associated medical conditions, and complications in patients aged ≥ 65 years undergoing MBS. Methods This retrospective analysis included patients aged ≥ 65 years who underwent MBS at the Medical University of Vienna between 2008 and 2025. Weight and associated medical complications were assessed at baseline and at 1, 2, and 5 years postoperatively. Early (< 30 days) and late complications up to 5 years were recorded. Results In total, 111 patients were included. Baseline weight was 125.8 ± 22.3 kg and BMI 45.2 ± 7.4 kg/ \:m² . At 5 years, mean BMI decreased to 27.5 ± 6.2 kg/ \:m² corresponding to a total weight loss of 37.3 ± 14.7%. The prevalence of type II diabetes decreased from 54.1% to 22.9% and arterial hypertension from 87.4% to 56.2%. Early and late complications each occurred in 7.2%. Conclusion MBS achieves substantial long-term weight reduction and remission of associated medical conditions. Complication rates are relatively high, underscoring careful patient selection is essential. Larger prospective studies focusing on elderly populations are warranted. Keypoints: MBS in elderly patients is effective in terms of weight loss and remission of associated medical complications. - MBS in elderly patients was associated with a relatively high complication rate. - Deaths within the study period were not associated with the MBS procedure.