Effects of laparoscopic sleeve gastrectomy on weight loss and metabolic improvement in subjects aged 65 years or older: a subanalysis of J-SMART study

Aim: To investigate the effect of weight loss and metabolic improvement after laparoscopic sleeve gastrectomy (LSG) in older adults aged 65 years or over compared with younger adults in a retrospective analysis. Methods: The J-SMART study database of 322 Japanese individuals with body mass index (BMI) ≥32 kg/m² who underwent LSG between 2011 and 2014 at 10 centers accredited by the Japanese Society for Treatment of Obesity were analyzed. The subjects were classified into two groups: ≥65 age group (range, 65–76 years; n = 25) and <65 age group (range, 22–64 years; n = 297). Clinical parameters were compared between the groups. Results: Baseline data for the ≥65 vs. <65 age groups were: median age 67 years vs. 45 years; weight 92.7 kg vs. 114.4 kg; BMI 40.0 kg/m² vs. 41.9 kg/m²; and HbA1c 6.8% vs. 6.5%. The ≥65 age group had significantly lower preoperative weight, BMI, estimated glomerular filtration rate, and ABCD score, but higher visceral fat area and prevalence of diabetes, hypertension, and obstructive sleep apnea (OSAS). Weight was significantly reduced in both groups throughout 5 years post-LSG, though total weight loss at 2 years was lower in the ≥65 age group (28.0%) than in the <65 group (30.0%). Remission rates of diabetes, hypertension, OSAS, and joint disorders 2 years after LSG showed no significant differences, except for dyslipidemia. Conclusion: LSG may be an efficacious option for improving obesity-related health problems in older adults. However, postoperative safety and complications were not evaluated in this study and further research is needed.