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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.
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.
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:
Complications and risks
Risks associated with surgery included micronutrient deficiencies and the need for additional abdominal procedures.
Additional abdominal procedures
One participant with known type 1 diabetes died from complications of diabetes unrelated to bariatric surgery 3.3 years after surgery.
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.