Bariatric Surgery: An Option for Adolescents With Obesity

Adolescents with obesity suffer from a lack of energy, feelings of physical weakness and lethargy, and a lowered self-esteem. This can lead to a dependence on food that ultimately delays adolescents’ progression into adulthood. However, a study has confirmed that through access to a healthy weight management plan centered on adolescence, including bariatric surgery or weight loss surgery as options for obese adolescents to stop the progression of their condition and achieve optimal long-term effects over time, such as improving their overall health, positive lifestyle choices and good body image.

The study published found that adolescents with obesity who underwent laparoscopic sleeve gastrectomy (LSG), a surgical procedure to reduce the size of the stomach and lower insulin resistance, benefited from less obesity and concomitant organ damage irrespective of their age during surgery. This has been applied to children as well as adolescents of age 13 years or older. It has been published online in Surgical Endoscopy.

Hassenfeld Children’s Hospital at NYU Langone and Children’s National Hospital in Washington, DC, and the researchers in these institutions, the study also revealed that adolescents with a parent who had underwent bariatric surgery had a higher weight prior to weight loss surgery, suggesting the familial nature of chronic obesity.

This study focuses on the physical and emotional complications associated with childhood obesity. Common health complications of children with obesity include, but are not limited to, type 2 diabetes, high blood pressure and high cholesterol. Adolescents with obesity may also suffer from depression and low self-esteem due to their condition.

Pediatric obesity is a medical condition in which an excess of body fat has accumulated to the extent that health may be negatively affected. The growth rate and energy expenditure of obese adolescents is increased relative to their non-obese peers, while resting metabolism remains normal. Obesity has been shown to have many adverse effects on health during adolescence, since it can cause hormone and metabolic changes as well as complications of pregnancy. An adolescent with obesity can potentially have reduced endurance, infertility and lower quality of life.

Childhood obesity occurs when a child is well above the healthy weight for their age and height. It is a complex and serious public health concern that continues to grow in prevalence. Pediatric obesity affects 14.4 million infants, children and adolescents ages 2 to 19 years, and the rate of obesity nearly doubled during the COVID-19 pandemic compared to a pre-pandemic period. This faster increase was most pronounced in younger, school-aged children.

Advertisement

“If obesity has negative effects on overall health, then why not take care of it early?” says study lead author Jun Tashiro, MD, MPH, a pediatric surgeon specializing in bariatric surgery at the Adolescent Healthy Weight Program, part of Hassenfeld Children’s Hospital at NYU Langone, and an assistant professor in the Division of Pediatric Surgery, in the department of surgery at NYU Langone Health. “Addressing the ‘toxic exposure’ with early interventions in any instance as long as it is safe will lower the negative consequences, such as high blood pressure, high cholesterol, diabetes, musculoskeletal problems, breathing problems, anxiety and depression.”

Bariatric surgery is a safe, effective treatment for healthy adolescents with a body mass index (BMI) of 35 or over who have failed traditional weight loss activities or are suffering from obesity-related health problems.

Advertisement

There are a growing number of studies designed to address the safety and effectiveness of bariatric surgery in this younger population, and recent reports highlight a number of health-related medical problems in severely obese teens, with a national consensus in favor of this treatment emerging in the norm for younger people. However, most facilities across the country are limited in their ability to treat adolescents under 16 years of age. For this reason, younger patients may not have access to periatric surgery like older people.

Implications of the Study

This new study evaluating the effects of parental history of bariatric surgery and age at the time of operation on 328 adolescents who undergo LSG shows that among the 31 percent of patients younger than 16 years, no differences in weight loss trends were demonstrated in comparison to the 69 percent 16 years or older. This study was done at Children’s National Hospital in Washington, DC, between January 2010 and December 2019. The study also demonstrated that the 76 patients with parental history of surgery had a higher absolute weight at the time of presentation, suggesting adherence to the familial, polygenic nature of obesity.

“Although there were no differences in weight loss outcomes for those patients whose parents have or have not had bariatric surgery themselves, given their heavier size at age of surgery, there may be benefit in ensuring even earlier access to care for these children and adolescents,” says Tashiro.

Diverse adolescent weight loss programs focus on the whole child and family, contributing to greater weight gain in psychological, social, nutritional, hormonal, genetic, activity, neurological and sleep. The authors of the study emphasize that independent pediatric hospitals or those with large adult facilities are unique in providing bariatric surgery to young patients, especially those under 16 years of age.

“This study shows that bariatric surgery is just as effective for younger adolescents as for older kids,” says study senior author Evan Nadler, MD, director of the Child and Adolescent Weight Loss Surgery Program at Children’s National Hospital. “Adolescents and teens with severe obesity face many significant barriers to accessing metabolic bariatric surgery, and while they wait, obesity-related comorbidities may continue to develop and impact their health. We as doctors should work together to remove these barriers when appropriate, so more young people who need this safe and effective treatment can get it.”

Further research is needed for the long-term comorbidities develop in adolescents with obesity for further understanding of the benefits of early bariatric surgery intervention.

Source-Medindia