Roux-en-Y gastric bypass is a safe and effective option that improves major Co-Morbidities associated with obesity in an older, veteran population.

Background: Though over one-third of veterans suffer from obesity and its associated comorbidities, bariatric surgery (deleted: is seldom offered) is less commonly offered than in other populations.

Methods: We reviewed surgical outcomes using CPRS/Vista data of ("deleted 308) 315 Roux-en-Y gastric bypass (RYGB) cases performed at a major VA Medical Center (1995-2017).

Results: Patients were 69% male, with an average age 52 (65% over 50), and were followed for an average of 8 years; 158 (51%) underwent laparoscopic surgery, and the remaining open. Outcomes were: 30-day mortality- Open: 1.3%, Lap: 0%; anatomic leak-open: 0.3%, Lap: 0%. A total of 32 (10%) Clavien-Dindo ≥3 complications occurred. At 5 and 15 years, average BMI decreased from 47 preoperatively to 33.3 and 31 respectively, while excess body weight loss was 68%, and 80%, respectively. Co-morbidity resolution rates were between 70 and 80% diabetes, sleep apnea, hyperlipidemia, GERD, (delete - hypertension), and NASH.

Conclusions: RYGB offers sustained, long-term weight loss with significant resolution of major comorbidities in older veterans, with acceptably low morbidity and mortality.