Weight loss surgery during adolescence yields greater health improvements

Using data from two similarly designed but independent prospective observational studies, the health outcomes of patients who had undergone gastric bypass surgery for the treatment of severe obesity as adolescents (13-19 years old) or adults (25 to 50 years old) were analysed 5 years post-surgery.

Whilst weight loss and rate of death at 5 years was similar between the two groups, researchers found that adolescents had greater remission of both type 2 diabetes and hypertension, two common obesity-related conditions. At baseline, 2% of adolescents and 12% of adults had diabetes of which 86% and 53% no longer met the criterion for diabetes at 5 years post-surgery. The proportion of patients on anti-hypertensive medication in both groups were similar at baseline but at 5 years, only 11% of adolescents still required them compared with 33% of adults. Overall, adolescents were 27% more likely to have diabetes remission and 51% more likely to have remission of hypertension.

A higher rate of abdominal re-operations and was reported in adolescents although the exact cause is unclear with authors suggesting closer monitoring and a lower threshold to re-operate in younger patients. Nutritional analyses at 2 years showed that the adolescent group had lower ferritin and vitamin D levels which were attributed to better postoperative supplement adherence among adults.

Why it matters: Bariatric surgery for treatment of severe obesity is usually performed in adulthood. Although longer-term data is needed, the findings suggest that surgery during adolescence may be more beneficial given the higher remission rate of obesity-related complications which are prevalent with age.

Source: The New England Journal of Medicine