Weight loss surgery in adolescence: Sustained remission of obesity-related conditions

 

Ten years after undergoing bariatric surgery as teens, over half of study participants demonstrated not only sustained weight loss, but also resolution of obesity-related conditions, such as type 2 diabetes, high blood pressure and high cholesterol, according to the report published in the New England Journal of Medicine.

“Our study presents impressive outcomes of the longest follow-up of weight loss surgery during adolescence, which validates bariatric surgery as a safe and effective long-term obesity management strategy,” said lead author Justin Ryder, PhD, Vice Chair of Research for the Department of Surgery at Ann & Robert H. Lurie Children's Hospital of Chicago and Associate Professor of Surgery and Pediatrics at Northwestern University Feinberg School of Medicine.

Nationally, bariatric surgery is under-utilized, with only one out of every 2,500 teens with severe obesity undergoing the procedure. In the U.S., almost five million adolescents are eligible for effective weight loss interventions like bariatric surgery, according to current recommendations.

Hillary Fisher, now 31, was pleased with her decision to undergo surgery at age 16. She was among the 260 adolescents who participated long term in the Teen-LABS study. 

“I was crushed by the daily issues I faced due to my weight, health problems and bullying in high school,” Ms. Fisher said. “After many unsuccessful attempts to lose weight, at 260 pounds, we decided bariatric surgery was the answer. It changed my life…the improved health and self-esteem that came with the 100-pound weight loss were important to me and I would certainly do it again.”  

Importantly, the study found that 55 percent of the participants who had type 2 diabetes as teenagers and underwent surgery were still in remission of their diabetes at 10 years. 

“This is considerably better than the outcomes reported in people who underwent bariatric surgery as adults, a major reason why treating obesity seriously in adolescents is so important,” added Dr. Ryder. 

Indeed, a recent multi-center randomized controlled trial found diabetes type 2 remission in adults to be 12-18 percent at seven to 12 years after bariatric surgery.

Teen-LABS investigators analyzed outcomes of 260 patients at 10 years after bariatric surgery as teenagers (13-19 years of age). They found that the body mass index (BMI) declined by 20 percent.

“The fascinating part is that when we use these operations in teenagers, the remission of health conditions like diabetes and high blood pressure are more durable than when operations are done later in adulthood,” said Thomas Inge, MD, PhD, Principal Investigator of the Teen-LABS study and Surgeon-in-Chief at Lurie Children’s.