What Are The Outcomes Of Bariatric Surgery in Teens?

With the increasing number of youth living with severe obesity and the lack of good conservative treatments, it is not surprising that the volume of bariatric surgery performed in adolescents is on the rise.

Now a study by Thomas Inge and colleagues, published in the New England Journal of Medicine, examines the efficacy and safety of bariatric surgery in teens.

The prospective study was conducted in 242 adolescents (mean age 17 y) undergoing Roux-en-Y gastric bypass (161 participants) or sleeve gastrectomy (67) at 5 US centres.

With the caveat that 15% of participants were lost to follow-up and laboratory data was missing in 24% of participants, the authors report that at 3 years, the mean weight had decreased by 27% with remission of type 2 diabetes in 95% of participants who had had the condition at baseline.

Other improvements in health included 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 those who had these conditions.

On the other hand, surgery was not without risks.: 57% of participants developed iron deficiencies and 13% of participants required at least one additional intraabdominal operation.

Thus, despite significant health benefits and improvement in quality of life, patients do have to be carefully monitored for nutritional deficiencies.

Obviously, 3 years is not a long period in the life of an adolescent and it will certainly take far longer follow-up to determine the durability of these findings.

Also, there remain significant questions about the psychosocial impact that surgery may have (both positive and negative) on the further development of these young participants.

Nevertheless, till we have better conservative treatments for severe obesity it appears that bariatric surgery may well be a viable treatment option for this population.

@DrSharma
Vancouver, BC