Younger teens just as likely to benefit from bariatric surgery as older adolescents

Younger teens at risk for severe obesity are just as likely as older adolescents to benefit from bariatric surgery and should not be denied consideration for the procedure on the basis of age, according to a study published in Pediatrics.

Sarah B. Ogle, DO, MS, a surgery fellow at Children’s Hospital Colorado and School of Medicine, and colleagues separated 242 teens who underwent bariatric surgery at five clinical centers in the U.S. into two categories based on their age. They compared the data of 66 teens aged 13 to 15 years and 162 aged 16 to 19 years.

“More recent adolescent studies reveal lower rates of complications in comparison with adults and comparable complication rates in both younger and older pediatric patients,” the authors wrote.

Study participants were enrolled in bariatric surgery between 2007 and 2012, and the authors collected baseline data within 30 days following surgery. Participants were then further evaluated after 6 months, 1 year, then annually for the next 4 years. Of the original 242 participants, 230 (95%) remained active in the study.

According to the authors, because of the small number of participants who underwent laparoscopic adjustable gastric banding (n =14), only those who underwent a Roux-en-Y gastric bypass (n =161) or vertical sleeve gastrectomy (n = 67) were included in the analysis. This group included a total of 228 participants.

At the time of the surgery, those in the younger cohort had an average baseline BMI score of 53.1 + 11, whereas the older cohort had an average baseline of 52.4 + 9. The authors reported similar trends in both cohorts following 5 years after their surgery — there was a decrease of 22.2% in the younger cohort (95% CI, –26.2% to –18.2%) and a decrease of 24.6% in the older group (95% CI, –27.7% to –22.5%).

At the time of the participants’ surgery, 27% (n = 18) of those in the younger cohort had hypertension compared with 37% (n = 59) of those in the older cohort. Remission of hypertension was achieved by 77% of the younger group (95% CI, 57.1%-100%), and 67% of those in the older group (95% CI, 54.5%-81.5%), 5 years after surgery.

Dyslipidemia was present among 73% (n = 47) of younger individuals at the time of surgery, and 77% (n =124) of older individuals. Remission was achieved by 61% (95% CI, 46.3%-81.1%) of younger participants and 58% (95% CI, 48%-68.9%) of older participants after 5 years.

The prevalence of type 2 diabetes was 11% (n = 7) among younger participants, and 14% (n = 22) among older participants at the time of surgery. After 5 years, remission was achieved by 83% of young participants (n = 6), and 87% of older participants (n = 15).

The authors then reported on the Impact of Weight on Quality of Life score for each participant. Across all measures, “values significantly improved by 6 months and remained similar thereafter.”

“[Metabolic and bariatric surgery] currently represents the most effective and durable, yet underused, treatment of severe obesity and complications of obesity in thoughtfully selected children,” the authors wrote.