Zeller Lab

Adolescent Bariatrics: Controlled Longitudinal Study of Psychosocial Development

Comprehensive studies of adolescent bariatric surgical outcomes are in their infancy. Adolescent bariatric surgery occurs at an important time in psychosocial development—a period of rapid change in emotional, interpersonal, social, and career/vocational domains in which good adaptation bodes well for continued positive adaptation in the transition to emerging adulthood (ages 18-20).

Bariatric surgery has the potential to positively alter the psychosocial and resultant developmental trajectory of adolescents with extreme obesity. TeenView (R01DK080020), an ancillary study to Teen-LABS, utilizes a prospective, controlled, longitudinal design and is following two parallel cohorts of adolescents over the same course of time: Teen-LABS participants (ages 14-18) and demographically similar non-operative extremely obese adolescents recruited from the five Teen-LABS sites. Both cohorts completed a series of measures at baseline/pre-surgery and at various time-points within the first two years post-surgery/follow-up. TeenView will document the positive impact of surgery on domains of age-salient adolescent psychosocial functioning (e.g., depressive symptoms, quality of life, perceived competence, peer victimization, social support, body image, developmental adaptation) and factors that may account for individual variations in psychosocial functioning (impaired parent/family functioning, high-risk behaviors, and high risk contexts such as child maltreatment).

Supplemental funds awarded from the National Institute on Drug Abuse (NIDA) allowed TeenView to expand it’s focus to include a more in depth examination of high-risk behaviors, including alcohol/tobacco/drug use, sexual risk behaviors, and suicide at the 24-month time point (TeenView2). TeenView’s addition of the demographically similar non-operative extremely obese comparison group will provide vital information regarding the natural course of adolescent extreme obesity—a context in which to evaluate the relative impact of bariatric surgery on the long-term psychosocial and developmental well being of extremely obese adolescents. Hence, the innovative aims and research design of this ancillary study will significantly enhance the scientific contribution of Teen-LABS.

Enrollment in TeenView is now closed and follow-up data collection is ongoing.

Tracking Adolescents after Bariatric Surgery: Substance, HIV, and Suicide Risks

The transition to emerging adulthood is a developmental period distinguished by age-related trends in high-risk behavior engagement, with alcohol, tobacco, and substance use, risky sexual behavior. Additionally, suicidal behavior may be experienced having initial onset and increasing rates in adolescence, followed by a peak in emerging adulthood and subsequent decline in the mid-twenties.

As bariatric surgery emerges as a viable treatment for adolescents with extreme obesity (BMI>40 kg/m²), it is imperative to identify the unique needs of the adolescent patient whose post-operative course occurs across this critical developmental phase.

The focus of TeenVIEW3 (R01DA033415) is the longer-term (36, 48-month) observation of these high-risk behavior trajectories during the transition to emerging adulthood. TeenVIEW3 is enrolling bariatric and non-operative comparison participants from the Teen-LABS consortium ancillary TeenView/TeenView2 (R01DK080020), which together provide the first prospective, controlled, observational studies of the psychosocial outcomes of adolescent bariatric surgery over the first four post-operative years.

TeenVIEW3 includes an examination of the effects of rapid changes in weight and psychosocial status resulting from bariatric surgery on trajectories of HIV/sexual-risk behaviors, alcohol/tobacco/drug use and suicide behaviors. It also includes an assessment of other developmentally important factors (e.g., dysregulation, impulsivity, reward-seeking, peer/family contexts) that may help explain the pathway from bariatric surgery to high-risk behaviors.

Findings from TeenVIEW3 hold promise for a substantial and long-term impact and will define clinical practice guidelines for this specific age group and vulnerable clinical population.

Data collection is ongoing.