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Do Tonsillectomies Promote Overweight?



We certainly know that the root causes of the obesity epidemic are far from straightforward and that the factors accused of playing a role (genes, environmental toxins, sleep deprivation, virus infections, dieting, just to name a few) is an ever increasing list.

It is, however, always important to remember that to conclusively prove causality takes more than just finding an association between factor XYZ and obesity – ideally, one would also have (human?) intervention data demonstrating that changing XYZ also changes body weight. And of course, we’d like to see everything tied together with a likely biologically plausible hypothesis.

So here is a story that was news to me: in this month’s issue of Pediatrics¬†Alet Wijga and colleagues from the National Institute for Public Health and the Environment, Bilthoven, Netherlands report that the accelerated weight gain (catch-up growth) after (adeno)tonsillectomy may increase the later risk of weight gain.

Their findings are based on an analysis of 3963 children participating in the Dutch Prevention and Incidence of Asthma and Mite Allergy birth cohort, which included not only data on weight and height, but also on adenoidectomy and tonsillectomy as well as a host of covariates (gender, birth weight, maternal education, maternal overweight, maternal smoking during pregnancy, breastfeeding, and smoking in the home).

According to their findings, (adeno)tonsillectomy between 0 and 7 years of age was significantly associated with overweight and obesity at age 8 – this finding was not explained by pre-existing overweight.

The authors suggest that the most likely explanation for this finding may indeed be the catch-up growth that often occurs once the adenoids and/or tonsils are out.

For a previous post on the possible detrimental effect of catch-up growth click here.

While I find this observation interesting, I am not sure what to do with this information. Clearly, you would not make a case for leaving infected and inflamed adenoids or tonsils in. Nor do I see parents depriving their faltering offspring of adequate nutrition to limit catch-up growth once the offending tissue is removed.

I guess this is one of those findings that make you wonder about just how connected things really are when it comes to body weight.

AMS
Edmonton, Alberta

2 Comments

  1. I wonder if there is any connectin between adenoid/tonsillectomy and the research about gut microbe colonization being different between obese and lean counterparts. (Gut Microbiota and Its Possible Relationship With Obesity John K. DiBaise, MD, Husen Zhang, PhD, Michael D. Crowell, PhD, Rosa Krajmalnik-Brown, PhD, G. Anton Decker, MBBCh, MRCP and Bruce E. Rittmann, PhD )
    What if the presence of tonsils help to ensure a certain type of microflora in the gut? What if removing them results in the colonization of a pro obesity strain or mix?
    How much do we really know about the inter relationships of all things – Systems thinking is generally harder than reductionism. What is our connection exactly with the other creatures (albeit tiny) on this planet.

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  2. I remember clearly that I gained weight after I had my tonsils removed when I was just a child. However, I could never figure out if it was due to the surgery or all of the ice cream and cold sugary beverages my mother & father stuffed down my throat to make me feel better. I’ve been searching for the reason I’m overweight… maybe knowing the reasons are useless when there are no cures.

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