Health
Weight loss after bariatric surgery in teens persists 10 years later
In adolescents, weight loss after bariatric surgery persists for 10 years, data from the Teen Bariatric Surgery Longitudinal Assessment (Teen-LABS) study confirmed.
Among 260 youth who underwent bariatric surgery, the mean change in body mass index (BMI) was -20% (95% CI -22.9 to -17.1; P<0.001), reported Justin R. Ryder, Ph.D., of the Ann and Robert H. Lurie Children's Hospital in Chicago, and colleagues.
Changes in BMI were significantly higher in patients undergoing gastric bypass (mean change -20.6%, 95% CI -24.8 to -16.4) or sleeve gastrectomy (mean change -19.2%, 95% CI -24.8 to -13.5). But it was the same. wrote on New England Medical Journal correspondence.
In addition to sustained weight loss, remission of comorbidities was also maintained for 10 years, including 55% of patients with type 2 diabetes, 57% of patients with hypertension, and 54% of patients with dyslipidemia.
To put this in perspective, the proportion of participants whose type 2 diabetes was in remission at 10 years was “much higher than the 18% and 12% of adults reported in one study at 7 and 12 years of age, respectively. Masu” Recent multicenter randomized controlled trials', the researchers pointed out.
“These data are recent guidance [from the American Academy of Pediatrics] “Given the recent use of effective anti-obesity drugs for surgical treatment of severely obese young people, we will directly investigate the relative effectiveness and risks of medical and surgical treatment approaches. Both are promising,” the group of riders said. To improve the lives and health of adolescents suffering from severe obesity. ”
According to recent researchthe number of adolescents and young adults prescribed GLP-1 receptor agonists has increased by nearly 600% over the past few years. Liraglutide (Saxenda) and Semaglutide (Wegovy) Both are approved for weight management in pediatric patients.
the rider said today's med page This is the “longest follow-up study of bariatric surgery in adolescents, with previous studies lasting less than five years.” Although he was not surprised by the results, he said, “We were pleased to see that bariatric surgery in adolescence remains a good treatment option for 10 years.”
“Adolescent bariatric surgery is a safe, effective and durable treatment option for young people with severe obesity,” he added. “Pediatricians and health care providers treating severely obese youth should consider referring these patients to children's hospitals with expertise in bariatric surgery.”
of Teen-LABS research We enrolled adolescents aged 13 to 19 years who underwent either gastric bypass (161 participants) or sleeve gastrectomy (99 participants) with a mean age of 17 years. Overall, 83% of postoperative 10-year visits were completed.
Looking at trends in weight loss, researchers identified four distinct BMI trajectories in the years following surgery.
- It reached a nadir at month 6 and then increased, with a 10-year change from baseline of +7.1%.
- It reached its lowest value after 1 year and then increased, with a 10-year change from baseline of -12.6%.
- It reached a nadir after 1 year but remained unchanged thereafter, with a 10-year change from baseline of -26.9%.
- It reached a nadir around year 5 and remained unchanged thereafter, with a 10-year change from baseline of -43.7%.
Cumulative logistic modeling showed that greater early weight loss (measured as change in BMI after 6 months) was associated with better long-term BMI trajectory (OR 1.16, 95% CI 1.11-1.21) .
This study had limitations including observational design, small sample size for certain comorbid conditions, and lack of a concurrent nonsurgical control group.
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disclosure
This research was supported by grants from the NIH, the National Center for Research Resources, and the National Center for the Advancement of Translational Science.
Ryder revealed its relationship with Boehringer Ingelheim and Calorify.
Collaborators reported relationships with Allurion Technologies, Eli Lilly and Company, Obesity Society, Independent Medical Experts, Mediflix, Medtronic, NIH, Standard Bariatrics, Teleflex Medical Incorporated, UpToDate, and Rhythm Pharmaceuticals.
primary source
New England Medical Journal
Source reference: Ryder JR et al. “Ten-year outcomes after bariatric surgery in adolescents” N Engl J Med 2024; DOI: 10.1056/NEJMc2404054.
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