Two studies by Cincinnati Children’s researchers demonstrate the promise of gastric bypass surgery for severely overweight teens.
At the November 2015 American Heart Association meeting, doctors reported on 50 patients who had the surgery as teens eight years prior. Their BMI had decreased by 32 percent, and cholesterol and triglycerides decreased from 85.7 to 38.3 percent.
By comparison, just eight of 30 teens in a non-surgical, medically supervised weight management program continued their program after 12 months. Their BMI increased by 6.2 percent overall after eight years, and lipids were unchanged.
Amy Shah, MD, Division of Endocrinology, and Tom Inge, MD, surgical director, Surgical Weight Loss Program for Teens, will monitor whether the lipid improvements seen in the surgical patients will reduce atherosclerosis and cardiovascular disease over time.
In another report in the Nov. 6, 2015, New England Journal of Medicine, doctors reviewed the multi-center Teen-LABS (Longitudinal Assessment of Bariatric Surgery) study. Teen-LABS enrolled 242 teens ages 13 to 19 who weighed an average of 325 pounds before surgery. Three years after surgery, their average weight had decreased by more than 90 pounds. Type 2 diabetes was reversed in 95 percent and kidney function normalized in 86 percent; hypertension and lipid abnormalities also reversed in many patients.
The promising results may underscore the advantages of earlier surgical intervention for obesity, researchers say.
“The remission rates for diabetes and hypertension were greater in teens than those we see in adult bariatric surgery patients,” says Inge. “It is possible that earlier intervention could lead to better outcomes.”
The surgery is not without challenges. Thirteen percent of patients required additional abdominal surgery, most commonly gallbladder removal, during the three-year period.
“Once teens are in these extremes of obesity, only 25 percent of them can achieve weights in the normal range after surgery, and over half remain severely obese even after surgery,” says co-author and bariatric surgeon Michael Helmrath, MD, MS.
With numbers of obese teens growing, gastroenterologist and co-author Stavra Xanthakos, MD, MS, says, “The study will help doctors have informed discussions with teens and families about the benefits and risks of bariatric surgery.”
Tom Inge, MD, and Amy Shah, MD