Bariatric Surgery Tied to Long-Term Weight Loss in Obese Adolescents

By Kelly Young

Edited by André Sofair, MD, MPH, and William E. Chavey, MD, MS

Bariatric surgery among obese adolescents is associated with long-term improvements in weight and cardiometabolic risk factors, according to a pair of studies in the Lancet Diabetes & Endocrinology.

In the first study, U.S. researchers followed 58 people who'd had Roux-en-Y gastric bypass before age 21 (mean BMI, 58.5 kg/m²). After a mean of 8 years, the average reduction in BMI was 16.9. However, nearly two-thirds still had a BMI of 35 or more.

In the second study, 81 Swedish teenagers with severe obesity (mean BMI, 45.5) underwent Roux-en-Y. At 5 years' follow-up, BMI was reduced by an average of 13.1, equivalent to 28% weight loss. This compares with a BMI increase of 3.3 among 72 control adolescents who underwent conservative treatment for obesity, and a BMI reduction of 12.3 among 71 obese adults who underwent Roux-en-Y.

In both studies, cardiometabolic risk factors like dyslipidemia and hypertension improved while nutritional deficiencies were common.

The Swedish authors write: "The literature base now seems sufficiently mature to consider formal integration of bariatric surgery into treatment pathways for adolescents with severe obesity."