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Weight Loss after Bariatric Surgery in Adolescents

Study also examines health status 3 years later

Publish date:: December 1, 2015

Three years after bariatric surgery in adolescents, significant improvements in weight, cardiometabolic health, and weight-related quality of life were observed in 242 patients undergoing weight-loss surgery. Patients undergoing Roux-en-Y gastric bypass (n=161) or sleeve gastrectomy (n=67) were included in the analysis. At 3 years after the procedure, researchers found:

• Mean weight has decreased by 27% in the total cohort, by 28% among gastric bypass patients, and by 26% among sleeve gastrectomy patients.

• Remission of type 2 diabetes occurred in 95% of participants who had the condition at baseline.

• Remission of abnormal kidney function occurred in 86%; remission of prediabetes in 76%; remission of elevated blood pressure in 74%; and remission of dyslipidemia in 66% of patients.

• 57% of patients who had the bariatric procedure experienced hypoferritinemia.

• 13% of the participants underwent additional intraabdominal procedures within 3 years of surgery.

Citation: Inge TH, Courcoulas AP, Jenkins TM, et al. Weight loss and health status 3 years after bariatric surgery in adolescents. [Published online ahead of print November 6, 2015]. N Engl J Med. doi: 10.1056/NEJMoa1506699.

Commentary: Obesity in children and adolescents has become a national epidemic. While primary prevention is of paramount importance, for those adolescents who are already morbidly obese and suffering severe cardiometabolic consequences from their obesity, this study delineates experience with bariatric surgery in a large group of adolescent individuals. Bariatric surgery has been shown to have important benefits in adults, leading to remission of diabetes in 50%-70% of those undergoing surgery and decreased total mortality over ten years including reduced deaths from diabetes, heart disease, and cancer (1). This study extends our knowledge of the benefits, and the risks - which include macro and micronutrient deficits such as iron and vitamin B12 - to patients in their teenage years. Patient selection remains the challenge, with bariatric surgery a consideration in the treatment of morbidly obese adolescents who have severe cardiometabolic consequences. —Neil Skolnik, MD

1. Adams TD, et al. Long-Term Mortality after Gastric Bypass Surgery. N Engl J Med 2007;357:753-61.

2. Dixon JB. Adjustable Gastric Banding and Conventional Therapy for Type 2 Diabetes A Randomized Controlled Trial. JAMA. 2008;299(3):316-323.

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