Gastric bypass surgery can help severely obese teenagers maintain their weight loss, although they may need to undergo additional procedures to deal with complications, two studies reported today.
The research, printed in the latest edition of The Lancet Diabetes & Endocrinology, are the first to examine the long-term effects of gastric bypass surgery among teens.
The first studied 58 severely obese American teenagers aged between 13 and 21 who underwent the surgery.
Before surgery, their average BMI was 59 and that reduced to 36 in the year afterwards. After eight years, the cohort’s average BMI was 42, which is the equivalent to a loss of 50kg per person or a 30% weight reduction.
However, 63% continued to register a BMI over 35, with only one person recording a weight in the normal BMI range of 18.5-25 at follow-up, said lead author Dr Thomas Inge, of Cincinnati Children’s Hospital Medical Center.
The number of teenagers with diabetes dropped from 16% to 2%, while high cholesterol rates fell from 86% to 38%. Surgery also accounted for a reduction in high blood pressure decreased from 47% to 16%.
The team found that 78% had low vitamin D levels, while 46% had mild anaemia, which could be a result of lower food consumption or impaired gut absorption.
Dr Inge said: “Now it is important to focus on delivery of the substantial health advantages of surgery while minimising these risks. Since there are currently two effective bariatric procedures, namely gastric bypass and vertical sleeve gastrectomy, we are currently examining the outcomes of both procedures to determine what is best for adolescents.”
The second study, carried out in Sweden, compared 162 people – 81 obese teenagers, whose average BMI was 45, and 81 adults with an average BMI of 43 – who had a gastric with 80 teenagers who did not undergo surgery.
Lead author Dr Torsten Olbers, University of Gothenburg, Sahlgrenska University Hospital, said that five years after surgery, all the teenagers and adults who had a gastric bypass recorded a reduced BMI by 13 points and 12 points respectively. However, the teens who did not have surgery saw their BMI increase from 42 to 45.
A quarter of the teenagers who had surgery had to undergo further procedures to treat complications from the bypass or as a result of rapid weight loss. These included 11 cases of bowel blockage and nine of gallstones.
“Gastric bypass results in substantial weight loss as well as cutting heart and metabolic problems and improving quality of life into the long-term for severely obese teenagers,” said Dr Olbers.
“While some patients may face complications, those given non-surgical treatment often continue to put on weight, putting them at higher risk of poor health throughout life. To reduce risk of complication, it’s important that gastric bypass for teenagers is done in centres that can provide the full care needed and long-term follow-up and support.”
Inge T, Jenkins T Xanthakos S et al. Long-term outcomes of bariatric surgery in adolescents with severe obesity (FABS-5+): a prospective follow-up analysis. Lancet Diabetes Endocrinol 5 January 2017 [abstract]
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