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

Introduction. Overweight and obesity are 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, comorbidity remission 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 comoridities 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. A total of 111 patients were included. Baseline weight was 125.8 ±22.3 kg and BMI 45.2 ±7.4 kg/m ² . At 5 years, mean BMI decreased to 27.5 ±6.2kg/m ² corresponding to a total weight loss of 37.3 ±14.7%. 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 obesity-related comorbidities. Complication rates are higher than in younger adults, underscoring careful patient selection is essential. Larger prospective studies focusing on elderly populations are warranted.