Original Scientific Articles

Long-Term Outcomes after Adolescent Bariatric Surgery

de la Cruz-Muñoz, Nestor MD; Xie, Luyu PHARMD; Quiroz, Hallie J MD; Kutlu, Onur C MD, FACS; Atem, Folefac PhD; Lipshultz, Steven E MD; Mathew, M Sunil MS; Messiah, Sarah E PhD, MPH

Author Information

From the Dewitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL (de la Cruz-Muñoz, Quiroz, Kutlu)

University of Texas Health Science Center, School of Public Health, Dallas, TX (Xie, Atem, Mathew, Messiah)

Center for Pediatric Population Health, UTHealth School of Public Health and Children’s Health System of Texas, Dallas, TX (Xie, Atem, Mathew, Messiah)

Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY (Lipshultz)

Oishei Children’s Hospital, Buffalo, NY (Lipshultz).

Received February 14, 2022; Revised April 20, 2022; Accepted April 21, 2022.

CME questions for this article available at http://jacscme.facs.org

Disclosure Information: Authors have nothing to disclose. Timothy J Eberlein, Editor-in-Chief, has nothing to disclose. Ronald J Weigel, CME Editor, has nothing to disclose.

Support: Drs Messiah, Atem, and Xie, and M. S. Mathew were funded by the National Institutes of Health, National Institute on Minority Health and Health Disparities (Grants R01MD011686 and R01MD011686-S1). Dr Lipshultz’s work was supported in part by the US Department of Health and Human Services Health Resources and Services Administration, Rockville, MD (HRSA-C76HF15614-10679 Pediatric Integrative Medicine Research Center), the National Center for Toxicological Research (NCTR-E0728711), the National Institutes of Health (HL072705, HL078522, HL053392, CA127642, CA068484, HD052104, AI50274, CA127642, CA068484, HD052102, HD052104, HL087708, HL079233, HL004537, HL087000, HL007188, HL094100, HL109090, HL111459, HL095127, HD80002, HD028820), the Laura Coulter-Jones Foundation (Division of Pediatric Clinical Research), the Batchelor Foundation (Batchelor Children’s Research Institute), the Children’s Cardiomyopathy Foundation, Sofia’s Hope Inc, the Kyle John Rymiszewski Foundation, the Children’s Hospital of Michigan Foundation, the Scott Howard Fund, and the Michael Garil Fund.

Disclaimer: The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or other funders.

Supplemental digital content is available for this article.

Correspondence address: Nestor de la Cruz-Muñoz, MD, University of Miami Miller School of Medicine, Department of Surgery, 3650 NW 82nd Ave, Suite 302, Doral, FL 33166. email: [email protected]

Journal of the American College of Surgeons 235(4):p 592-602, October 2022. | DOI: 10.1097/XCS.0000000000000325

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BACKGROUND:

Metabolic and bariatric surgery (MBS) is a safe and effective treatment option for adolescents with severe obesity, but no long-term studies are available with more than10 years of follow-up data to document sustained improved outcomes.

METHODS:

A total of 96 patients who completed MBS at 21 years of age or younger in a tertiary academic center 2002 to 2010 were contacted for a telehealth visit. Body weight, comorbidity status, social/physical function status, and long-term complications were evaluated 10 to 18 years after surgery.

RESULTS:

Mean participant (83% female, 75% Hispanic) age at MBS was 18.8 (±1.6) years (median age 19 years, range 15–21 years), and median pre-MBS BMI was 44.7 kg/m² (SD 6.5). At follow-up (mean 14.2 [±2.2] years) post-MBS (90.6% Roux-en-Y gastric bypass [RYGB] or 8.3% laparoscopic adjustable gastric banding [LAGB]) mean total body weight decreased by 31.3% (interquartile range [IQR] 20.0% to 38.9%); 32.0% (IQR, 21.3% to 40.1%) among RYGB participants and 22.5% (IQR, 0.64% to 28.3%) among LAGB participants. Patients with pre-MBS hyperlipidemia (14.6%), asthma (10.4%), and diabetes/hyperglycemia (5.2%) reported 100% remission at follow-up (p < 0.05 for all). Pre–post decrease in hypertension (13.5% vs 1%, p = 0.001), sleep apnea (16.7% vs 1.0%, p < 0.001), gastroesophageal reflux disease (13.5% vs 3.1%, p = 0.016), anxiety (7.3% vs 2.1%, p = 0.169), and depression (27.1% vs 4.2%, p < 0.001) were also found.

CONCLUSIONS:

Significant sustained reductions in weight and comorbidities, and low rates of long-term complications, a decade or more after completing MBS as an adolescent were found. These findings have important implications for adolescents who may be considering MBS for weight reduction and overall health improvements that extend into adulthood.