HOUSTON — Weight loss surgery can sound extreme for a child. However, researchers have found that such a procedure can have long-lasting benefits as they reach adulthood. Researchers in Texas found that children and young adults under 22 who underwent bariatric surgery for severe obesity managed to keep the weight off over the next decade.
In one of the longest follow-up studies on adolescents with severe obesity, the researchers found that 31.3 percent kept the weight off for more than 10 years. There was also a 100-percent remission in cases of diabetes, asthma, and elevated lipids (fats).
“There are long-term benefits to completing bariatric surgery before the age of 22,” explains Sarah Messiah, PhD, MPH, senior author of the study and director of the Center for Pediatric Population Health at UTHealth School of Public Health-Dallas, in a media release. “The durability of the positive health outcomes isn’t well known this far out at this young age. It’s been a gap in understanding that this research has helped fill.”
💡What Is Bariatric Surgery?
Bariatric surgery refers to several different surgical procedures that are performed to treat obesity. These procedures make changes to the digestive system to limit how much food the stomach can hold, causing the patient to feel fuller sooner and thus eat less.
Some of the most common bariatric surgery procedures include:
- Gastric Bypass – The stomach is divided into a small upper pouch and a larger remnant pouch. The small intestine is rerouted to the small pouch, bypassing the remnant pouch.
- Sleeve Gastrectomy – A large portion of the stomach is surgically removed, leaving a banana-shaped sleeve or pouch. This reduces the stomach’s capacity.
- Adjustable Gastric Band – An inflatable band is placed around the upper portion of the stomach to create a small pouch, limiting food intake.
- Biliopancreatic Diversion with Duodenal Switch – Part of the stomach is removed to create a smaller pouch and sections of the small intestine are rerouted.
The most common requirement for bariatric surgery is having a body mass index over 40 or having a BMI between 35 and 40, along with an obesity-related disease. Most likely, medical providers will require proof of past attempts to lose weight before approving an operation.
“It’s like a deep sigh of relief to see results that validated we have been doing good for 20 years for these patients, even if they were lost to follow-up,” says bariatric surgeon Nestor de la Cruz-Munoz. “Some of these children are severely depressed, and if we can change these kids’ lives while they are in high school or before they go to college, it can give them a fresh start and hope for a better life.”
In the United States, there is a disproportionate number of obesity cases among ethnically diverse adolescents. About 12 percent of Black adolescents and nine percent of Hispanic children between 12 and 19 years-old are in the range of severe obesity — compared to seven percent of non-Hispanic White adolescents.
Having severe obesity puts you at higher risk for cancer and chronic diseases such as heart disease, diabetes, kidney disease, and liver disease. Before the surgery, 14.6 percent of patients had high levels of fat in the blood, 10.4 percent had asthma, and 5.2 percent experienced diabetes or high blood sugar levels.
There were 96 study participants in the follow-up trial. Immediately following the surgery, the BMI of patients dropped from 44.9 to 25.2, averaging a 44.4-percent decrease. The remission rate was 100 percent for asthma and diabetes. There was also a noticeable drop in high blood pressure, sleep apnea, anxiety, gastroesophageal reflux disease, and depression.
After a decade, 86.5 percent showed improved dietary habits since surgery, and 60.4 percent engaged in regular exercise. In more than half of women, 67 percent experienced a successful pregnancy and birth.
“Adolescents are the fastest-growing segment of the severe obesity epidemic in the U.S., and the COVID-19 pandemic has exacerbated the problem,” notes Messiah. “The evidence from this study supports recent recommendations from the American Academy of Pediatrics to increase access to surgery for adolescents. We hope this data could change barriers to access for these children.”
The study is published in the Journal of the American College of Surgeons.
