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Professor and Chairman, Department of Pediatric Surgery, Children’s Hospital Colorado
Chief, Minimally Invasive Bariatric & General Surgery, University of Pittsburgh Medical Center
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, Sr Associate Dean of Student Affairs at Baylor College of Medicine
Professor of Surgery at University at Buffalo, State University of New York
Chief of Bariatric and Minimally Invasive Surgery, Stanford University School of Medicine
Metabolic Medicine Physician, University College Dublin
Co-Director Center for Weight Management and Metabolic Surgery, Brigham and Women's Hospital
Chief of Minimally Invasive General Surgery, Director of the Cleveland Clinic Bariatric and Metabolic Institute
Professor and Chair in Obesity Research and Management at University of Alberta
Director, Nutrition and Weight Management Center, Boston Medical Center
Professor of Bariatric and MIS Surgery, Director of the obesity chair at King Saud University
General and Bariatric Surgeon at IRCCS Azienda Ospedaliera Universitaria San Martino IST - Istituto Nazionale per la Ricerca sul Cancro
Research Associate Professor of Pediatrics and Public Health Sciences at University of Miami Miller School of Medicine
Director, Center for Adolescent Bariatric Surgery at NewYork-Presbyterian Morgan Stanley Children's Hospital
Clinical Director, Pediatric Surgery at Nemours
Associate Professor of Pediatrics at University of North Carolina at Chapel Hill
Lead Consultant Bariatric Surgeon at Sahlgrenska University Hospital
Metabolic and bariatric surgeon-scientist investigator at Vanderbilt University
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.
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.
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.
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.)
Professor and Chairman, Department of Pediatric Surgery, Children’s Hospital Colorado
Chief, Minimally Invasive Bariatric & General Surgery, University of Pittsburgh Medical Center
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, Sr Associate Dean of Student Affairs at Baylor College of Medicine
Professor of Surgery at University at Buffalo, State University of New York
Chief of Bariatric and Minimally Invasive Surgery, Stanford University School of Medicine
Metabolic Medicine Physician, University College Dublin
Co-Director Center for Weight Management and Metabolic Surgery, Brigham and Women's Hospital
Chief of Minimally Invasive General Surgery, Director of the Cleveland Clinic Bariatric and Metabolic Institute
Professor and Chair in Obesity Research and Management at University of Alberta
Director, Nutrition and Weight Management Center, Boston Medical Center
Professor of Bariatric and MIS Surgery, Director of the obesity chair at King Saud University
General and Bariatric Surgeon at IRCCS Azienda Ospedaliera Universitaria San Martino IST - Istituto Nazionale per la Ricerca sul Cancro
Research Associate Professor of Pediatrics and Public Health Sciences at University of Miami Miller School of Medicine
Director, Center for Adolescent Bariatric Surgery at NewYork-Presbyterian Morgan Stanley Children's Hospital
Clinical Director, Pediatric Surgery at Nemours
Associate Professor of Pediatrics at University of North Carolina at Chapel Hill
Lead Consultant Bariatric Surgeon at Sahlgrenska University Hospital
Metabolic and bariatric surgeon-scientist investigator at Vanderbilt University