Adolescents with Severe Obesity Lost Weight and Sustained it After Bariatric Surgery, New Research Finds

Adolescents with severe obesity who underwent bariatric surgery before the age of 22 had significant sustained reductions in weight and comorbidities a decade or more after surgery, according to a new analysis published in the Journal of the American College of Surgeons.

Researchers from the University of Texas Health Science Center in Houston and the University of Miami found that at a mean follow-up of 14.4 years after undergoing bariatric surgery, mean total body weight decreased by 31.3% among participants. Also, investigators noted that participants had a 100% remission in diabetes, asthma, and elevated lipids.

“There are long-term benefits to completing bariatric surgery before the age of 22,” said senior author Sarah Messiah, PhD, MPH, professor, and director of the Center for Pediatric Population Health at UTHealth School of Public Health-Dallas, in a press release. “The durability of the positive health outcomes isn’t well known this far out at this young age. It’s been a gap in understanding that this research has helped fill.”

A total of 96 patients (mean age, 18.6 years; 83% women; 75% Hispanic) who completed metabolic and bariatric surgery (MBS) at 21 years of age or younger were enrolled in the study. The median pre-MBS body mass index (BMI) among participants was 45 kg/m2.

Approximately 90% of participants underwent Roux-en-Y gastric bypass (RYGB) and 8.3% underwent laparoscopic adjustable gastric banding (LAGB).

After surgery, mean total body weight decreased by 31.3% among RYGB participants and 22.5% among LAGB participants, according to the team. Patients with pre-MBS hyperlipidemia (14.6%), asthma (10.4%), and type 2 diabetes (5.2%) reported 100% remission at follow-up. Also, pre-post decreases were found in the following comorbidities:

• Hypertension (13.5% vs 1%, p=.001)
• Sleep apnea (16.7% vs 1%, p<.001)
• Gastroesophageal reflux disease (13.5% vs 3.1%, p=.016)
• Anxiety (7.3% vs 2.1%, p=.169)
• Depression (27.1% vs 4.2%, p<.001)

“Adolescents are the fastest-growing segment of the severe obesity epidemic in the U.S., and the COVID-19 pandemic has exacerbated the problem,” said Messiah in the release. “The evidence from this study supports recent recommendations from the American Academy of Pediatrics to increase access to surgery for adolescents. We hope this data could change barriers to access for these children.”