According to a recent study of clinical characteristics of teens who underwent laparoscopic Roux-en-Y gastric bypass surgery from 2002 until 2007, doctors may have a much narrower window of opportunity to reverse morbid obesity in teens than previously thought.
The study, conducted at Cincinnati Children's Hospital Medical Center, appears in the current online edition of the Journal of Pediatrics.
The study focused on 61 teens who underwent laparoscopic Roux-en-Y gastric bypass at Cincinnati Children's. The results of the study showed that one year after the study, BMI in the overall group of teens pre-surgery decreased by 37 percent, however because of their starting weights, the teens were still considered to be morbidly obese. This means that doctors can predict what a patient's weight will be one-year post weight loss surgery.
Lead author of the study, Thomas Inge, MD, PhD, Associate Professor of Surgery and Pediatrics, explains that "Current guidelines for adolescent weight loss surgery suggest that we begin to consider surgery only after a teen is 80-100 percent overweight. Our new data show that when we intervene when a patient is between 100 and 150 percent over ideal weight, we can expect successfully resolution of obesity. But by the time the teen is 200 percent over their ideal weight for age, the surgery will reduce their weight substantially, but many of the patients will still remain morbidly obese.
This is the first study in adolescents to specifically show that the postoperative weight is strongly influenced by the patient's starting weight. This finding raises a concern that waiting until children are super obese to begin to think of surgery may result in major weight loss, but not resolution of obesity and certain medical problems than intervening at an early stage of the disease. For instance, in those who remain significantly obese following surgery, this excess weight can have negative effects on joints and mobility; the long-term risks of remaining seriously overweight are unknown.
Co-author Dr. Stavra Xanthakos, Assistant Professor of Pediatrics and pediatric gastroenterologist feels that, "We [doctors] have to do a better job of identifying teens who are gaining enormous amounts of weight quickly and get help for them earlier." Dr. Xanthakos says that when doctors or parents notice that a teen is beginning to gain weight rapidly, there should be a staged approach to managing the weight problem. "If the weight gain is not effectively stopped with initial nutritional or exercise measures, then even more intensive treatments or programs are indicated, and ultimately some very serious thought has to be given to surgery," said Dr. Xanthakos.