Abstract
INTRODUCTION: The rising prevalence of obesity among the elderly poses unique challenges. While life expectancy has improved due to advancements in medical care, this increase in longevity does not necessarily correlate with an improved quality of life. Instead, the obesity epidemic, particularly in the later decades of life, is linked to a heightened demand for healthcare services and higher healthcare costs. This study aimed to analyze bariatric surgeons' perspectives on the role of anti-obesity medications (AOMs) in metabolic bariatric surgery (MBS) for patients over 65, focusing on treatment preferences in clinical scenarios. Additionally, an obesity treatment algorithm for older patients was proposed. MATERIAL AND METHODS: A survey was conducted among bariatric surgeons worldwide from September to October 2024, including questions on demographics, experience, and clinical scenarios. A questionnaire specifically designed for the purposes of this study was used. RESULTS: Of 184 respondents from 53 countries, 77.2% reported prescribing AOMs. Sleeve gastrectomy is most preferred as the primary surgical option for patients over 65. Treatment preferences varied by BMI, with AOMs favored for a BMI of 30-35 kg/m(2), and MBS preferred for higher BMIs. CONCLUSIONS: This study highlights the integration of AOMs into obesity management for older adults, with sleeve gastrectomy as the primary surgical choice. Treatment choices were consistent across surgeon demographics, underscoring the need for tailored approaches in elderly obesity care.