In a large study of teens who received bariatric surgery, scientists have found the procedure was effective at maintaining the patients’ weights and treating other weight-related conditions for three years afterward — outcomes that are even better than those generally seen in adults.
“The data are pointing us to teens having better results than adults,” said Dr. Thomas Inge, a pediatric surgeon at Cincinnati Children’s Hospital Medical Center and the study’s lead investigator.
Obesity is on the rise among children and teens. The percentage of obese adolescents aged 12–19 has increased from 5 percent in 1980 to nearly 21 percent in 2012, according to the Centers for Disease Control and Prevention. Many teens are turning to weight-loss surgery. Adolescent bariatric surgeries more than doubled in number from 2003 to 2009.
There are several types of these surgeries. Most reduce food intake by restricting the amount of food the digestive system can hold or process. Others make the digestion of fat or carbohydrates more difficult.
For the National Institutes of Health-funded study, doctors observed 228 teenage patients at five treatment centers across the United States. Nearly all had initial body mass indices of more than 40, the level which is deemed morbidly obese.
Teens in the study received one of two common bariatric surgeries — Roux-en-Y gastric bypass or sleeve gastrectomy — and were followed for three years after the procedure.
Teens who received either surgery showed significant improvements in both their weight and quality of life at the end of the study period. Cholesterol and blood pressure levels dropped in most of the youth who had elevated levels at the start of the study. Others saw their kidney disease and prediabetes disappear. The results were published Friday in the New England Journal of Medicine.
Teens who received bariatric surgery showed significant improvements in both their weight and quality of life.
Those findings are impressive compared to the typical outcomes of adults receiving bariatric surgery, Inge said.
“The expectation for remission of type 2 diabetes after surgery is 50-70 percent in adults, but in the teens we studied it was 95 percent,” he said.
He added that while only 40 percent of adults could expect a remission of hypertension after bariatric surgery, 70 percent of the teens in the study had a significant drop in hypertensive blood pressure.
The results indicate that bariatric surgery can be a good long-term weight-loss tool for very obese teens. It does carry risks, however. The researchers found that patients had some nutrient deficiencies after the surgery, primarily iron and vitamin B12. These were usually managed with supplements. And 13 percent of subjects needed follow-up abdominal procedures over three years.
The overall outcome, wrote the authors, “leads us to hypothesize that adolescents may have a greater potential than adults for reversal of the cardiometabolic consequences of obesity.”
