Bariatric Surgery for Severe Obesity Growing Among Teens

The Teen LABS study showed impressive results three years after surgery.

Reprinted from Eating Disorders Review
March/April Volume 27, Number 2
©2016 IAEDP

Bariatric surgery for severe obesity has become relatively common in adults, and its use is growing among adolescents. People who have undergone or are contemplating bariatric surgery are frequently encountered by eating disorder clinicians working with adults, and this will undoubtedly be increasingly true for those working with adolescents as well.

The results of a large, multi-center cohort study of bariatric surgery in adolescents, the Teen LABS study, were recently published in the New England Journal of Medicine(NEJM. 2016. 374:113). In this study, held at 5 medical centers, 242 adolescents (mean age: 17 years) and with a mean body mass index, or kg/m2, of 53 underwent bariatric surgery at 5 centers; three-fourths were female. The authors reported three-year outcome data for weight, impact on comorbid medical problems, and complications.

Results three years after surgery

At the three-year follow-up point, the gastric bypass group had a mean 28% weight loss, compared with a mean 26% weight loss among those receiving sleeve gastrectomy. Type II diabetes mellitus remitted in 95% of those who had the disease prior to surgery. Similarly impressive rates of remission were seen for abnormal renal function (86% remission), pre-diabetes mellitus (76% remitted), hypertension (74% remitted) and elevated cholesterol or triglyceride levels (66% remitted). In addition, weight-related quality-of-life ratings improved at three-year follow-up.

There were some complications. First, low ferritin levels were seen in 57%, vitamin A deficiency developed in 16%, and 13% of participants required at least one additional abdominal surgical procedure during the three-year follow-up.

Clearly, there will be more information to come on other outcomes in the Teen LABS study, just as there was in the larger, adult-focused bariatric surgery study, LABS. This information will be valuable in assessing the diverse effects from gastric surgery, including the psychosocial impact. In the meantime, the amount of weight loss achieved at three years and the impact on co-occurring medical problems strongly suggest there will be increasing interest in the use of gastric surgery in adolescents.