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Study Authors
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Professor and Chairman, Department of Pediatric Surgery, Children’s Hospital ColoradoThomas Inge, MD, PhD, FACS, FAAP
Professor and Chairman, Department of Pediatric Surgery, Children’s Hospital ColoradoProfessor and Chairman, Department of Pediatric Surgery, Children’s Hospital Colorado
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Chief, Minimally Invasive Bariatric & General Surgery, University of Pittsburgh Medical CenterAnita Courcoulas, MD, MPH, FACS
Chief, Minimally Invasive Bariatric & General Surgery, University of Pittsburgh Medical CenterChief, Minimally Invasive Bariatric & General Surgery, University of Pittsburgh Medical Center
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Professor of Surgery and Pediatrics, The Ohio State University, College of Medicine. Surgical Director, Center for Healthy Weight & Nutrition, Nationwide Children's Hospital, Columbus, OhioMarc Michalsky, MD, FACS, FAAP
Professor of Surgery and Pediatrics, The Ohio State University, College of Medicine. Surgical Director, Center for Healthy Weight & Nutrition, Nationwide Children's Hospital, Columbus, OhioProfessor of Surgery and Pediatrics, The Ohio State University, College of Medicine. Surgical Director, Center for Healthy Weight & Nutrition, Nationwide Children's Hospital, Columbus, Ohio
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Professor of Surgery, Sr Associate Dean of Student Affairs at Baylor College of MedicineMary Brandt, MD
Professor of Surgery, Sr Associate Dean of Student Affairs at Baylor College of MedicineProfessor of Surgery, Sr Associate Dean of Student Affairs at Baylor College of Medicine
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Professor of Surgery at University at Buffalo, State University of New YorkCarroll Harmon, MD, PhD
Professor of Surgery at University at Buffalo, State University of New YorkProfessor of Surgery at University at Buffalo, State University of New York
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Experts
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Chief of Bariatric and Minimally Invasive Surgery, Stanford University School of MedicineJohn Morton, MD, MPH, FACS, FASMBS
Chief of Bariatric and Minimally Invasive Surgery, Stanford University School of MedicineChief of Bariatric and Minimally Invasive Surgery, Stanford University School of Medicine
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Metabolic Medicine Physician, University College DublinCarel Le Roux, MBChB, FRCP, FRCPath, PhD
Metabolic Medicine Physician, University College DublinMetabolic Medicine Physician, University College Dublin
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Co-Director Center for Weight Management and Metabolic Surgery, Brigham and Women's HospitalAli Tavakkoli, MD
Co-Director Center for Weight Management and Metabolic Surgery, Brigham and Women's HospitalCo-Director Center for Weight Management and Metabolic Surgery, Brigham and Women's Hospital
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Chief of Minimally Invasive General Surgery, Director of the Cleveland Clinic Bariatric and Metabolic InstitutePhilip Schauer, MD, FACS
Chief of Minimally Invasive General Surgery, Director of the Cleveland Clinic Bariatric and Metabolic InstituteChief of Minimally Invasive General Surgery, Director of the Cleveland Clinic Bariatric and Metabolic Institute
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Professor and Chair in Obesity Research and Management at University of AlbertaArya Sharma, MD, PhD
Professor and Chair in Obesity Research and Management at University of AlbertaProfessor and Chair in Obesity Research and Management at University of Alberta
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Director, Nutrition and Weight Management Center, Boston Medical CenterCaroline Apovian, MD, FACP, FACN
Director, Nutrition and Weight Management Center, Boston Medical CenterDirector, Nutrition and Weight Management Center, Boston Medical Center
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Professor of Bariatric and MIS Surgery, Director of the obesity chair at King Saud UniversityAayed Al Qahtani, MD, FRCSC, FACS
Professor of Bariatric and MIS Surgery, Director of the obesity chair at King Saud UniversityProfessor of Bariatric and MIS Surgery, Director of the obesity chair at King Saud University
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General and Bariatric Surgeon at IRCCS Azienda Ospedaliera Universitaria San Martino IST - Istituto Nazionale per la Ricerca sul CancroFrancesco Saverio Papadia, MD, FACS
General and Bariatric Surgeon at IRCCS Azienda Ospedaliera Universitaria San Martino IST - Istituto Nazionale per la Ricerca sul CancroGeneral and Bariatric Surgeon at IRCCS Azienda Ospedaliera Universitaria San Martino IST - Istituto Nazionale per la Ricerca sul Cancro
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Research Associate Professor of Pediatrics and Public Health Sciences at University of Miami Miller School of MedicineSarah Messiah, PhD, MPH
Research Associate Professor of Pediatrics and Public Health Sciences at University of Miami Miller School of MedicineResearch Associate Professor of Pediatrics and Public Health Sciences at University of Miami Miller School of Medicine
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Director, Center for Adolescent Bariatric Surgery at NewYork-Presbyterian Morgan Stanley Children's HospitalJeffrey Zitsman, MD
Director, Center for Adolescent Bariatric Surgery at NewYork-Presbyterian Morgan Stanley Children's HospitalDirector, Center for Adolescent Bariatric Surgery at NewYork-Presbyterian Morgan Stanley Children's Hospital
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Clinical Director, Pediatric Surgery at NemoursKirk Reichard, MD, MBA, FACS, FAAP
Clinical Director, Pediatric Surgery at NemoursClinical Director, Pediatric Surgery at Nemours
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Associate Professor of Pediatrics at University of North Carolina at Chapel HillAsheley Skinner, PhD
Associate Professor of Pediatrics at University of North Carolina at Chapel HillAssociate Professor of Pediatrics at University of North Carolina at Chapel Hill
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Lead Consultant Bariatric Surgeon at Sahlgrenska University HospitalTorsten Olbers, MD
Lead Consultant Bariatric Surgeon at Sahlgrenska University HospitalLead Consultant Bariatric Surgeon at Sahlgrenska University Hospital
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Lead Moderators
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Metabolic and bariatric surgeon-scientist investigator at Vanderbilt UniversityVance Albaugh, MD, PhD
Metabolic and bariatric surgeon-scientist investigator at Vanderbilt UniversityMetabolic and bariatric surgeon-scientist investigator at Vanderbilt University
About the Discussion
@NEJM Ask the Authors & Experts: Weight Loss and Health Status 3 Years after Bariatric Surgery in Adolescents
Original Article
Weight Loss and Health Status 3 Years after Bariatric Surgery in Adolescents
Background
Bariatric surgery is increasingly considered for the treatment of adolescents with severe obesity, but few prospective adolescent-specific studies examining the efficacy and safety of weight-loss surgery are available to support clinical decision making.
Methods
We prospectively enrolled 242 adolescents undergoing weight-loss surgery at five U.S. centers. Patients undergoing Roux-en-Y gastric bypass (161 participants) or sleeve gastrectomy (67) were included in the analysis. Changes in body weight, coexisting conditions, cardiometabolic risk factors, and weight-related quality of life and postoperative complications were evaluated through 3 years after the procedure.
Results
The mean (±SD) baseline age of the participants was 17±1.6 years, and the mean body-mass index (the weight in kilograms divided by the square of the height in meters) was 53; 75% of the participants were female, and 72% were white. At 3 years after the procedure, the mean weight had decreased by 27% (95% confidence interval [CI], 25 to 29) in the total cohort, by 28% (95% CI, 25 to 30) among participants who underwent gastric bypass, and by 26% (95% CI, 22 to 30) among those who underwent sleeve gastrectomy. By 3 years after the procedure, remission of type 2 diabetes occurred in 95% (95% CI, 85 to 100) of participants who had had the condition at baseline, remission of abnormal kidney function occurred in 86% (95% CI, 72 to 100), remission of prediabetes in 76% (95% CI, 56 to 97), remission of elevated blood pressure in 74% (95% CI, 64 to 84), and remission of dyslipidemia in 66% (95% CI, 57 to 74). Weight-related quality of life also improved significantly. However, at 3 years after the bariatric procedure, hypoferritinemia was found in 57% (95% CI, 50 to 65) of the participants, and 13% (95% CI, 9 to 18) of the participants had undergone one or more additional intraabdominal procedures.
Conclusions
In this multicenter, prospective study of bariatric surgery in adolescents, we found significant improvements in weight, cardiometabolic health, and weight-related quality of life at 3 years after the procedure. Risks associated with surgery included specific micronutrient deficiencies and the need for additional abdominal procedures. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases and others; Teen-LABS ClinicalTrials.gov number, NCT00474318.)
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Study Authors
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Professor and Chairman, Department of Pediatric Surgery, Children’s Hospital ColoradoThomas Inge, MD, PhD, FACS, FAAP
Professor and Chairman, Department of Pediatric Surgery, Children’s Hospital Colorado
Professor and Chairman, Department of Pediatric Surgery, Children’s Hospital Colorado
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Chief, Minimally Invasive Bariatric & General Surgery, University of Pittsburgh Medical CenterAnita Courcoulas, MD, MPH, FACS
Chief, Minimally Invasive Bariatric & General Surgery, University of Pittsburgh Medical Center
Chief, Minimally Invasive Bariatric & General Surgery, University of Pittsburgh Medical Center
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Professor of Surgery and Pediatrics, The Ohio State University, College of Medicine. Surgical Director, Center for Healthy Weight & Nutrition, Nationwide Children's Hospital, Columbus, OhioMarc Michalsky, MD, FACS, FAAP
Professor of Surgery and Pediatrics, The Ohio State University, College of Medicine. Surgical Director, Center for Healthy Weight & Nutrition, Nationwide Children's Hospital, Columbus, Ohio
Professor of Surgery and Pediatrics, The Ohio State University, College of Medicine. Surgical Director, Center for Healthy Weight & Nutrition, Nationwide Children's Hospital, Columbus, Ohio
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Professor of Surgery, Sr Associate Dean of Student Affairs at Baylor College of MedicineMary Brandt, MD
Professor of Surgery, Sr Associate Dean of Student Affairs at Baylor College of Medicine
Professor of Surgery, Sr Associate Dean of Student Affairs at Baylor College of Medicine
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Professor of Surgery at University at Buffalo, State University of New YorkCarroll Harmon, MD, PhD
Professor of Surgery at University at Buffalo, State University of New York
Professor of Surgery at University at Buffalo, State University of New York
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Experts
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Chief of Bariatric and Minimally Invasive Surgery, Stanford University School of MedicineJohn Morton, MD, MPH, FACS, FASMBS
Chief of Bariatric and Minimally Invasive Surgery, Stanford University School of Medicine
Chief of Bariatric and Minimally Invasive Surgery, Stanford University School of Medicine
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Metabolic Medicine Physician, University College DublinCarel Le Roux, MBChB, FRCP, FRCPath, PhD
Metabolic Medicine Physician, University College Dublin
Metabolic Medicine Physician, University College Dublin
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Co-Director Center for Weight Management and Metabolic Surgery, Brigham and Women's HospitalAli Tavakkoli, MD
Co-Director Center for Weight Management and Metabolic Surgery, Brigham and Women's Hospital
Co-Director Center for Weight Management and Metabolic Surgery, Brigham and Women's Hospital
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Chief of Minimally Invasive General Surgery, Director of the Cleveland Clinic Bariatric and Metabolic InstitutePhilip Schauer, MD, FACS
Chief of Minimally Invasive General Surgery, Director of the Cleveland Clinic Bariatric and Metabolic Institute
Chief of Minimally Invasive General Surgery, Director of the Cleveland Clinic Bariatric and Metabolic Institute
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Professor and Chair in Obesity Research and Management at University of AlbertaArya Sharma, MD, PhD
Professor and Chair in Obesity Research and Management at University of Alberta
Professor and Chair in Obesity Research and Management at University of Alberta
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Director, Nutrition and Weight Management Center, Boston Medical CenterCaroline Apovian, MD, FACP, FACN
Director, Nutrition and Weight Management Center, Boston Medical Center
Director, Nutrition and Weight Management Center, Boston Medical Center
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Professor of Bariatric and MIS Surgery, Director of the obesity chair at King Saud UniversityAayed Al Qahtani, MD, FRCSC, FACS
Professor of Bariatric and MIS Surgery, Director of the obesity chair at King Saud University
Professor of Bariatric and MIS Surgery, Director of the obesity chair at King Saud University
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General and Bariatric Surgeon at IRCCS Azienda Ospedaliera Universitaria San Martino IST - Istituto Nazionale per la Ricerca sul CancroFrancesco Saverio Papadia, MD, FACS
General and Bariatric Surgeon at IRCCS Azienda Ospedaliera Universitaria San Martino IST - Istituto Nazionale per la Ricerca sul Cancro
General and Bariatric Surgeon at IRCCS Azienda Ospedaliera Universitaria San Martino IST - Istituto Nazionale per la Ricerca sul Cancro
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Research Associate Professor of Pediatrics and Public Health Sciences at University of Miami Miller School of MedicineSarah Messiah, PhD, MPH
Research Associate Professor of Pediatrics and Public Health Sciences at University of Miami Miller School of Medicine
Research Associate Professor of Pediatrics and Public Health Sciences at University of Miami Miller School of Medicine
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Director, Center for Adolescent Bariatric Surgery at NewYork-Presbyterian Morgan Stanley Children's HospitalJeffrey Zitsman, MD
Director, Center for Adolescent Bariatric Surgery at NewYork-Presbyterian Morgan Stanley Children's Hospital
Director, Center for Adolescent Bariatric Surgery at NewYork-Presbyterian Morgan Stanley Children's Hospital
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Clinical Director, Pediatric Surgery at NemoursKirk Reichard, MD, MBA, FACS, FAAP
Clinical Director, Pediatric Surgery at Nemours
Clinical Director, Pediatric Surgery at Nemours
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Associate Professor of Pediatrics at University of North Carolina at Chapel HillAsheley Skinner, PhD
Associate Professor of Pediatrics at University of North Carolina at Chapel Hill
Associate Professor of Pediatrics at University of North Carolina at Chapel Hill
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Lead Consultant Bariatric Surgeon at Sahlgrenska University HospitalTorsten Olbers, MD
Lead Consultant Bariatric Surgeon at Sahlgrenska University Hospital
Lead Consultant Bariatric Surgeon at Sahlgrenska University Hospital
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Lead Moderators
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Metabolic and bariatric surgeon-scientist investigator at Vanderbilt UniversityVance Albaugh, MD, PhD
Metabolic and bariatric surgeon-scientist investigator at Vanderbilt University
Metabolic and bariatric surgeon-scientist investigator at Vanderbilt University
