I also had the surgery in my 50s and I'm now 72. I was very pleased with the weight loss and how it helped resolve my knee arthritis pain and sleep apnea. It also helped me move a lot more easily -- I had no idea how nice it would feel to be able to easily cross my legs! I really don't see age as a barrier to the surgery at all. There are various forms of the surgery, and I would encourage you to think through your priorities (side effects, reversal potential, likely weight loss, etc) before you make a final choice.

Having said that, I went in with constipation issues, and came out with constipation issues. Also, dumping syndrome is real. In my case (everyone's experience is different), I went through a LOT of trial and error to learn what did and did not trigger my nausea, which in my case varies day to day -- I usually have trouble with soft grain products like bread (toast is fine) or pancakes, sometimes have issues with cruciferous vegetables, sometimes have issues with other vegetables, never have issues with any form of protein or fruit. Went on a FODMAP elimination diet for a while, but no, that isn't it. Also, it isn't gluten. It's just strange. However, I would do the surgery again in a heartbeat -- it was worth it.

And yes, at this age, our skin does not bounce back. So everything sags. Whether you go for plastic surgery is up to you, of course, but if you lose substantial weight at this age using any mechanism, sagging surface layers are going to be an issue. And the sagging in the belly in particular can be pretty spectacular if you lose enough weight. Also, the skin on my thighs wrinkles when I move.

One of the problems with the new GLP-1RA drugs is that there is no prep and no follow-up -- they just throw you in the deep end. In contrast, I had to do a LOT of prep before the surgery, and there was a lot of helpful follow-up. When you get hooked up with a surgeon, ask about all of that. (And ask at what point you can cancel without running into insurance problems -- that is, when is a commitment locked in.)

I know nothing about chronic fatigue syndrome. I suspect you'll want to be working with a physical therapist who specializes in people who are coping with this issue, since exercise is a critical part of not losing debilitating amounts of muscle mass (so is prioritizing protein in your diet).

You may also find that you can eliminate some medications as you lose the weight, which may help. For example, I'm off statins, which turned out to have been triggering orthostatic hypotension. That wasn't a problem at my original weight, but by the end of the weight loss, it was.