Bariatric Surgery in Teens Linked to Sustained Weight Loss and Improved Metabolic Health, 10-Year Study Shows

(COLUMBUS, Ohio) - A new analysis shows that more than half of the teens participating in a multisite study who had bariatric surgery experienced sustained weight loss and improvement in obesity-related conditions such as type-2 diabetes, high blood pressure and high cholesterol over a 10-year span.

The current report, published Oct. 30 in the New England Journal of Medicine, represents ongoing analysis from the largest and most rigorous prospective study of adolescent patients with severe obesity undergoing metabolic and bariatric surgery and provides the most comprehensive analysis of long-term outcomes to date, said Marc Michalsky, MD, FACS, FAAP, FASMBS, surgical director for the Center for Healthy Weight and Nutrition at Nationwide Children's Hospital and co-author on the study.

Nationwide Children's Hospital is one of only five institutions nationally to take part in the Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) research study, funded by the National Institutes of Health (NIH), to understand the benefits and risks of bariatric surgery in adolescents over time.

"The most recent analysis from the Teen-LABS study consortium supports the evolving consensus that bariatric surgery is a safe, effective and durable treatment strategy designed to improve the health of children suffering from severe forms of obesity," Dr. Michalsky said. "In addition to demonstrating significant and long-term weight loss up to 10 years, the study demonstrates improvement in several key obesity-related co-morbid illness including hypertension, type 2 diabetes and dyslipidemia."

The study analyzed the outcomes of 260 patients 10 years after bariatric surgery as teenagers (13 to 19 years of age), and observed a mean reduction of 20% in body mnass index (BMI) and significant improvements in rates of blood pressure, type 2 diabetes, and other obesity-related co-morbid illnesses. Long-term remission of type 2 diabetes in this pediatric study group (57%) far exceeds reported long term remission rates in recent studies of adult bariatric patients, Dr. Michalsky said. In addition, comparative anlsysis of long-term weight loss outcomes associated with gastric bypass versus sleeve gastrectomy appear to be similar. Additionally, investigors observed that greater weight loss in the initial 6 months following bariatric surgery was associated with more favorable long-term BMI trajectory.

"Obesity is one of the most common chronic conditions among adolescents in the United States, and it can result in serious health outcomes if not treated," said Dr. Stephen Cook, director of the Center for Healthy Weight and Nutrition at Nationwide Children's Hospital. "Treating children and teens with obesity requires a thoughtful, wholistic approach. We have shown that bariatric surgery is a safe and effective option to treat this complex, chronic disease. Components of care should include lifestyle changes including diet and physical activity, behavioral changes or therapies, and when appropriate weight loss medications or metabolic and bariatric surgery."

The Teen-LABS study consortium, led by Dr. Thomas Inge, Lurie Children's Hospital, includes co-investigators at Nationwide Children's Hospital, Cincinnati Children's Hospital Medical Center, Texas Children's Hospital, Children's Hospital of Alabama and the University of Pittsburgh Medical Center.

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