Lancet Studies - Gastric Bypass Helps Severely Obese Teenagers

London, UK — Two recent follow-up studies posted in The Lancet Diabetes & Endocrinology have suggested that gastric bypass surgery helps severely obese teenagers lose weight and keep it off, while some patients will likely need further surgery to deal with the complications of rapid weight loss or may develop vitamin deficiencies later in life.

Severe obesity is classified as having a BMI of 40 or over and affects around 4.6 million children and teenagers in the United States, causing poor health and quality of life and cutting life expectancy.

The studies focused on teenagers who had undergone the procedure 5-12 years prior and are the first look at the long-term effects of gastric bypass surgery in teenagers. Though the success rate of the procedure had previously been unknown, thousands of teenagers are offered this treatment each year.

In the first paper, conducted by scientists from Cincinnati Children’s Hospital Medical Center and Baker IDI Heart and Diabetes Institute, researchers looked at 58 American teenagers aged 13-21 who were severely obese and had had gastric bypass surgery.

A year after the surgery, average BMI had lowered from 59 to 36 and eight years later, average BMI was 42, equivalent to a 30% weight reduction. However, almost two thirds of cases remained very obese (BMI over 35) and only one became normal weight at follow-up.

Rates of diabetes in the teenagers dropped from 16 percent to 2 percent, high cholesterol sunk from 86 percent to 38 percent, and high blood pressure decreased from 47 percent to 16 percent as a result of surgery. Some had low levels of vitamin D (78 percent) and B12 (16 percent) and mild anemia (46 percent), which researchers believe could be a result of lower food consumption or impaired gut absorption.

“Weight loss is crucial for severely obese patients who face poor health and shorter lifespans,” said lead author Dr. Thomas Inge of Cincinnati Children’s Hospital Medical Center. “These two manuscripts clearly document long-term benefits of adolescent bariatric treatment, but also highlight several nutritional risks.” Link

The second study, conducted by various universities from Sweden looked at 81 obese teens and 81 adults in Sweden who had a gastric bypass and 80 teens that had not had the surgery.

That study found that five years after the procedure, teenagers and adults had a reduced BMI, whereas the teenagers who did not have surgery had an increased BMI. Additionally, of teenagers who underwent gastric bypass, 25 percent had further surgery to treat complications from the bypass or as a result of rapid weight loss, including bowel blockage and gallstones. A quarter of teenagers in the control group (those who did not have surgery) went on to have a gastric bypass as an adult during the study follow-up.

“Gastric bypass results in substantial weight loss as well as cutting heart and metabolic problems and improving quality of life into the long-term for severely obese teenagers,” said lead author Dr. Torsten Olbers of the University of Gothenburg, Sahlgrenska University Hospital, Sweden. “While some patients may face complications, those given non-surgical treatment often continue to put on weight, putting them at higher risk of poor health throughout life. To reduce risk of complication it’s important that gastric bypass for teenagers is done in centers that can provide the full care needed and long-term follow-up and support.” Link

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