New findings support benefits of bariatric surgery in severely obese adolescents

Eighty to 90% of adolescents benefit from lasting weight loss following bariatric surgery, and most experience the remission of obesity-related complications such as elevated blood pressure, high cholesterol, type 2 diabetes and musculoskeletal pain, among others. In a new study published in Obesity, researchers at Children's Hospital Colorado (Children's Colorado) have shown that, with the exception of cholesterol and triglyceride levels, remission of obesity-related complications was not dependent on major sustained weight loss. Rather, a majority of adolescents benefited from remission of obesity-related complications, an observation that was independent of whether or not they lost a significant amount of weight.

We view the findings of this study to be very encouraging. Because the amount of weight loss does not seem to impede the sustained remission of many obesity-related complications, the study supports the myriad benefits of bariatric surgery for severely obese teens. These patients are often able to stop taking medications for Type 2 diabetes and high blood pressure following surgery. In doing so, not only does their quality of life dramatically improve, but no longer incurring the cost of managing such complications can offset the cost of surgery over time."

Sarkis Christopher (Chris) Derderian, MD, pediatric surgery fellow at Children's Colorado

In the study, Derderian and colleagues compared rates of remission of obesity-associated complications among two groups of patients: those who experienced less than 20% total body weight loss five years after surgery and those who experienced 20% or greater total body weight loss over the same time period. All 192 study participants were part of a multi-center study led by researchers at Children's Colorado known as the Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS).

Specifically, researchers found that 40.6% of study participants exhibited <20% total body weight loss while 59.4% exhibited >20% total body weight loss at five years. While the latter group saw greater improvement in their cholesterol levels, the remission of other complications appeared to be independent of whether or not the participants achieved major sustained weight loss.

"In looking at the relationship between the extent of weight loss and health benefits obtained, it is clear that patients' health improves regardless of whether or not they sustain high levels of weight loss long-term following surgery," said Thomas H. Inge, MD, PhD, Teen-LABS principal investigator, and director of pediatric surgery and the bariatric center at Children's Colorado. "While this study is incredibly promising, additional research is needed to determine if the same benefits are seen in patients who only sustain weight loss of five to 10% over time. Nevertheless, this study supports the recognition of bariatric surgery as the most effective intervention to promote significant and durable weight loss in adolescents with severe obesity."

This study utilized data from Teen-LABS. Teen-LABS was established in 2007 and is the largest and only multicenter, NIH-sponsored research on adolescent bariatric surgery. Teen-LABS is an ongoing study involving six clinical centers around the U.S., including Children's Hospital Colorado, Cincinnati Children's Hospital Medical Center, Nationwide Children's Hospital, Texas Children's Hospital, Children's Hospital of Alabama and the University of Pittsburgh Medical Center.

Source:
Journal reference:

Derderian, S.C., et al. (2020) Influence of Weight Loss on Obesity‐Associated Complications After Metabolic and Bariatric Surgery in Adolescents. Obesity. doi.org/10.1002/oby.23038.

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