Children's Hospital Colorado

Examining Weight Loss and Health Outcomes Three Years After Adolescent Bariatric Surgery

Bariatric Surgery | February 16, 2018


For families

  • Bariatric surgery has become a popular treatment for severely obese teens, but research on its safety and effectiveness is lacking.
  • Researchers at our Bariatric Surgery Center studied patient outcomes three years after teen bariatric surgery.
  • The researchers found many benefits to bariatric surgery and a few risks.

For health professionals

  • Prospective studies examining the efficacy and safety of adolescent bariatric surgery are lacking.
  • This multicenter prospective study found significant improvements in weight, cardiometabolic health and weight-related quality of life three years after surgery.
  • Risks of bariatric surgery in adolescents included micronutrient deficiencies and the need for additional abdominal procedures.

Research background: A need for research on effectiveness and safety of weight-loss surgery for obese adolescents

The occurrence of severe obesity in children and adolescents in the U.S. has reached 4.4 million, yet there are few effective treatments available. While bariatric surgery has gained popularity for the treatment of severely obese adolescents, there is a lack of research on the effectiveness and safety of weight-loss surgery to support clinical decision-making.

A multidisciplinary study at five U.S. medical centers, including the Bariatric Surgery Center at Children’s Hospital Colorado, sought to address questions about efficacy and safety. The study reviewed data on participants’ weight loss, coexisting conditions, weight-related quality of life, micronutrient levels and additional abdominal procedures during the three years after their bariatric procedure

Research methods: Study of patient outcomes three years after adolescent bariatric surgery

Between 2007 and 2012, 242 adolescents (age 19 or younger) undergoing weight loss surgery were enrolled in the study. There were 161 participants who underwent a Roux-en-Y gastric bypass, 67 who underwent gastric sleeve surgery and 14 who underwent adjustable gastric banding at one of the study sites.

  • Mean participant age: 17±1.6 years
  • Mean body mass index: 53
  • 75 percent of the participants were female
  • 72 percent were white 

 Illustration of Roux-en-Y gastric bypass and vertical sleeve gastrectomy surgeries

Research results: Weight loss and other positive bariatric surgery results and incidence of complications

The study found significant improvements in weight, cardiometabolic health and weight-related quality of life at three years after the weight-loss procedure. Risks associated with surgery included specific micronutrient deficiencies and the need for additional abdominal procedures.

Improvements at three years after procedure:

  • Decrease of 27 percent in mean weight
    • 28 percent among those who underwent gastric bypass
    • 26 percent among those who underwent gastric sleeve surgery
  • 95 percent remission of type 2 diabetes in participants with condition at baseline
  • 86 percent remission of abnormal kidney function
  • 76 percent remission of prediabetes
  • 74 percent remission of elevated blood pressure
  • 66 percent remission of dyslipidemia
  • Significant improvement in weight-related quality of life (baseline score of 63 increased to 83)
  • 26 percent of the participants no longer obese
    • 89 percent achieved 10 percent or greater reduction in BMI
    • 85 percent achieved 10 percent or greater reduction in BMI
4.4 Million U.S. children and adolescents are severely obese
242 study participants
27% mean weight decrease three years after weight-loss surgery

Complications and risks

Risks associated with surgery included micronutrient deficiencies and the need for additional abdominal procedures.

Additional abdominal procedures

  • 13 percent required one or more additional intra-abdominal procedure within three years
    • Three procedures unrelated to the previous bariatric procedure
  • 24 percent performed in first year after bariatric procedure
    • 55 percent within second year
    • 21 percent within third year

Mortality

One participant with known type 1 diabetes died from complications of diabetes unrelated to bariatric surgery 3.3 years after surgery.

Research conclusion: Benefits and risks of adolescent bariatric surgery should be considered

The vast majority of study participants experienced marked improvements in health and in weight. In particular, the reversal of type 2 diabetes, high blood pressure and kidney disorders in most of these study participants was a remarkable finding. Quality of life improvements were also noted after surgery. Micronutrient deficiencies can occur and thus nutritional supplements are required after surgery. As with any major abdominal surgery, complications requiring additional surgery are possible and must be discussed when evaluating the risks and benefits of surgery.


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