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Bariatric surgery unsuccessful in Prader-Willi syndrome
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A small study suggests that bariatric surgery did not result in long-term, sustainable weight loss or a reduction in comorbidities for adults with Prader-Willi syndrome despite early weight loss, according to findings published in Pediatric Obesity.
“Bariatric surgery cannot be recommended as a standard treatment for Prader-Willi syndrome. Genetic obesity is not correctable by surgical means,” Shirley Liu, MD, FRCSEd, FACS, head of the endocrine surgery division at Prince of Wales Hospital, Chinese University of Hong Kong, told Endocrine Today.
In a prospective, observational study, Liu and colleagues analyzed data from five adults with Prader-Willi syndrome who underwent bariatric surgery and attended multidisciplinary follow-up programs (two men; mean age, 19 years; mean BMI, 47.3 kg/m²). Between 2008 and 2013, participants underwent sleeve gastrectomy (n = 2), anastomosis gastric bypass (n = 2) and RouxenY gastric bypass. The median follow-up was 8.4 years.
Mean BMI for the cohort fell from 47.3 kg/m² to 36.5 kg/m² during the first year (P = .04) and to 35.3 kg/m² at 2 years (P = .04). Lowest body weight was achieved at 2 years, with mean percentage of total weight loss of 24.7%. Percentage of total weight loss decreased to 23.3% at 3 years, 11.9% at 5 years, 4.1% at 8 years and zero at 10 years.
“After the second year, there was progressive weight rebound,” the researchers wrote. “The mean BMI increased to 36 kg/m² at 3 years, 38.9 kg/m² at 4 years, 41.6 kg/m² at 5 years and 43 kg/m² at 6 years. After the sixth year, the mean BMI returned to baseline and even increased further.”
Additionally, each patient had at least three comorbidities preoperatively, but none of them had resolution of any one of the comorbidities at the last followup, the researchers wrote.
“Because of the rarity of Prader-Willi syndrome, researchers should be encouraged to report their long-term results of bariatric surgery on Prader-Willi syndrome patients,” Liu said. “A meta-analysis or systematic review would be very helpful to appreciate the objective values of bariatric surgery in treating Prader-Willi syndrome.” – by Regina Schaffer
For more information:
Shirley Liu, MD, FRCSEd, FACS, can be reached at Prince of Wales Hospital, Department of Surgery, Faculty of Medicine, the Chinese University of Hong Kong, 30-32 Ngan Shing St., Sha Tin, New Territories, Hong Kong; email: liuyw@surgery.cuhk.edu.hk.
Disclosures: The authors report no relevant financial disclosures.
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