Purpose. Obesity has reached epidemic proportions in the U.S. and has nearly doubled worldwide since 1980. Bariatric surgery is on the rise, but little focus has been placed on the psychosocial impacts of surgery. The purpose of this study was to explore experiences of patients who have undergone bariatric surgery at least two years before to gain an understanding of the successes and challenges they have faced since surgery. Methods. This study used a phenomenological approach, to investigate the meaning and essence of bariatric patients with food after surgery. Semi-structured interviews were conducted on a sample of nine participants who had undergone surgery at least two years prior. Findings. Two main themes regarding food intake emerged from the data: (a) food after the first year post-surgery and (b) bariatric surgery is not a magic pill. Upon further analysis, food after the first year post-surgery had four subthemes emerge: diet adherence after the first year post-surgery, food intolerances, amount of food, and tendencies toward coping with food do not magically disappear. Conclusion. Findings revealed that post-operative diet and exercise adherence becomes increasingly difficult as weight loss slows. Many participants find that only after the first year after surgery the work really begins.

This article provides a commentary on the costs of obese nursing home patients. We conducted a comprehensive literature search, which found 46 relevant articles on obesity in older adults and effects on nursing home facilities. This review indicated obesity is increasing globally for all age groups and older adults are facing increased challenges with chronic diseases associated with obesity more than ever before. With medical advances comes greater life expectancy, but obese adults often experience more disabilities, which require nursing home care. In the United States, the prevalence of obesity in adults aged 60 years and older increased from 9.9 million (23.6%) to 22.2 million (37.0%) in 2010. Obese older adults are twice as likely to be admitted to a nursing home. Many obese adults have comorbidities such as Type 2 diabetes; patients with diabetes incurred 1 in every 4 nursing home days. Besides the costs of early entrance into nursing facilities, caring for obese residents is different than caring for nonobese residents. Obese residents have more care needs for additional equipment, supplies, and staff costs. Unlike emergency rooms and hospitals, nursing homes do not have federal requirements that require them to serve all patients. Currently, some nursing homes are not prepared to deal with very obese patients. This is a public health concern because there are more obese people than ever in history before and the future appears to have even a heavier generation moving forward. Policymakers need to become aware of this serious gap in nursing home care.

The aging population is growing exponentially worldwide. Associated with this greater life expectancy is the increased burden of chronic health conditions, many of which are exacerbated by the continued rise in obesity. In the US, the prevalence of obesity in adults aged 60 years and older increased from 23.6% to 37% in 2010.Objectives:This review examines bariatric surgery as a treatment option for obese adults > 60 years old. The most common types of weight-loss surgery are laparoscopic adjustable gastric banding, vertical sleeve gastrectomy, Roux-en-Y gastric bypass, and the duodenal switch.Methods:A comprehensive literature search found 349 articles that referred to bariatric surgery in older adults. Of these, 70 relevant articles on bariatric surgery for older adults were utilized for this article.Results:Weight-loss surgery procedures were found to be equally safe for both older adults and their younger counterparts. Pre-surgical psychological assessment is critical for positive outcomes for older adults. Benefits of bariatric surgery include a decrease in comorbidities, chronic disease risk, and medication use coupled with improved mobility and quality of life outcomes. Side effects include surgical failure, changes in psychological status, and increased physical and mental stress.Conclusions:Bariatric surgery can offer patients an effective and long-lasting treatment for obesity and related diseases. There does not appear to be any one bariatric procedure that is recommended for older adults, so individual needs should be taken into consideration when exploring options. Costs range from US$17,000 for laparoscopic procedures to US$26,000 for open gastric surgeries. Estimated savings start accruing within 3 months of surgery making bariatric surgery a serious cost saving consideration.

Bariatric surgery has become an accepted method to treat obesity and its related diseases in adults; nevertheless, few bariatric surgery follow-up studies compare changes in body mass index (BMI), disease outcomes, and side effects among age groups. This study compares bariatric surgery outcomes across four adult age groups by comparing changes in milestone BMIs such as highest and lowest BMI, perceived existing disease outcomes, and symptoms related to those diseases. Data were obtained using a 40-item questionnaire that was mailed to 2,520 patients of a Midwestern weight management center who were at least 18 months post-bariatric surgical procedure. The 534 respondents were divided into four age groups in years: 18 to 49 (n = 171), 50-59 (n = 148), 60-69 (n = 138), and ≥ 70 (n = 77). There were no differences among the age groups for lowest (p = .93) and current BMI (p = .51). Significant improvement in eight chronic diseases occurred across all age groups. There were no differences between age groups in reported occurrence of incontinence (p = .65), diarrhea (p = .22), flatulence (p = .46), heartburn (p = .73), and indigestion (p = .22). Constipation rarely occurred among the oldest adults (p < .001). Bariatric surgery should be considered an option for weight loss and disease management for older adults as much as it is for younger adults.