Outcomes of Bariatric Surgery in Older Versus Younger Adolescents

Abstract

Objectives: In this report, we compare weight loss, comorbidity resolution, nutritional abnormalities, and quality of life between younger and older adolescents after metabolic and bariatric surgery.

Methods: From March 2007 to December 2011, 242 adolescents (≤19 years of age) who underwent bariatric surgery at 5 clinical centers in the United States were enrolled in the prospective, multicenter, long-term outcome study Teen-Longitudinal Assessment of Bariatric Surgery. Outcome data from younger (13-15 years; n = 66) and older (16-19 years; n = 162) study participants were compared. Outcomes included percent BMI change, comorbidity outcomes (hypertension, dyslipidemia, and type 2 diabetes mellitus), nutritional abnormalities, and quality of life over 5 years post surgery.

Results: Baseline characteristics, except for age, between the 2 cohorts were similar. No significant differences in frequency of remission of hypertension (P = .84) or dyslipidemia (P = .74) were observed between age groups. Remission of type 2 diabetes mellitus was high in both groups, although statistically higher in older adolescents (relative risk 0.86; P = .046). Weight loss and quality of life were similar in the 2 age groups. Younger adolescents were less likely to develop elevated transferrin (prevalence ratio 0.52; P = .048) and low vitamin D levels (prevalence ratio 0.8; P = .034).

Conclusions: The differences in outcome of metabolic and bariatric surgery between younger and older adolescents were few. These data suggest that younger adolescents with severe obesity should not be denied consideration for surgical therapy on the basis of age alone and that providers should consider adolescents of all ages for surgical therapy for obesity when clinically indicated.

Trial registration: ClinicalTrials.gov NCT00474318.

Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: Dr Inge has served as a consultant for Zafgen Corporation, Biomedical Insights, and L&E Research and has received honoraria from Standard Bariatrics, UpToDate, and Independent Medical Expert Consulting Services, all unrelated to this project; the other authors have indicated they have no potential conflicts of interest to disclose.

Copyright © 2021 by the American Academy of Pediatrics.

Figures

FIGURE 1

Percentage BMI change and comorbidity resolution over 5 years after MBS. A, Percentage BMI change from baseline. B, Remission of hypertension. C, Remission of dyslipidemia. D, Remission of type 2 diabetes mellitus. Younger adolescents were less likely to achieve remission of diabetes (P = .046). Error bars indicate 95% CIs.

FIGURE 2

Micronutrient status over 5 years after MBS and age group associations with micronutrient abnormalities. Micronutrient status was similar over 5 years after surgery. Younger adolescents were less likely to have elevated transferrin (P = .048) or low vitamin D (P = .034) levels compared with older adolescents. Bars represent 95% CIs. Box symbols represent PRs.