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Long-term weight loss after bariatric procedures for morbidly obese adolescents and youth: a single-institution analysis with up to 19-year follow-up

  • 2022 SAGES Oral
  • Published:
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A Correction to this article was published on 24 August 2022

This article has been updated

Abstract

Background

Obesity is a public health concern among adolescents and young adults. Bariatric surgery is the most effective treatment for morbid obesity and has been increasingly utilized in young patients. Long-term outcomes data for bariatric surgery in this age group are limited.

Methods

This is a single-institution, prospective analysis of 167 patients aged 15–24 years who underwent one of three laparoscopic bariatric procedures between 2001 and 2019: Roux-en-Y gastric bypass (LRYGB, n = 71), adjustable gastric banding (LAGB, n = 22), and sleeve gastrectomy (LSG, n = 74). Longitudinal weight and body mass index (BMI) measurements were compared to evaluate patterns of weight loss.

Results

All operations were completed laparoscopically using the same clinical pathways. Patients were predominantly female (82.6%), had a median age of 22.0 [Q1-Q3 20.0–23.0] years, and had a mean presurgical BMI of 48.5 ± 6.5 kg/m2 (range 38.4–68.1 kg/m2). All procedures produced significant weight loss by 1 year, peak weight loss by 2 years, and modest weight regain after 5 years. Mean percent weight/BMI losses at 5 years for LRYGB, LAGB, and LSG were − 36.7 ± 10.8%, − 14.5 ± 15.3%, and − 25.1 ± 13.4%, respectively (p < 0.001). LRYGB patients were most likely to achieve ≥ 25% weight loss at 1, 3, and 5 years and maintained significant average weight loss for more than 15 years after surgery. Reoperations were procedure-specific, with LAGB, LRYGB, and LSG having the highest, middle, and lowest reoperation rates, respectively (40.9% vs. 16.9% vs. 5.4%, p < 0.001).

Conclusion

All procedures provided significant and durable weight loss. LRYGB patients achieved the best and most sustained weight loss. LSG patients experienced second-best weight loss between 1 and 5 years, with lowest chance of reoperation. LAGB patients had the least weight loss and the highest reoperation rate. Compared to other factors, type of bariatric procedure was independently predictive of successful weight loss over time. More studies with long-term follow-up are needed.

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Acknowledgements

PHM and PG conceived the study concept and design. PG provided clinical material and data. KK and AJ verified data accuracy and performed data entry. PHM performed the data analysis. PHM and PG prepared the manuscript. WG, MEZ, and PG provided critical insight and revision of the manuscript. All authors reviewed the manuscript and gave final approval before submission.

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No funding was obtained for this study. None of the authors assume any financial interest or support.

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Authors and Affiliations

  1. Department of Surgery, NewYork-Presbyterian Brooklyn Methodist Hospital, 506 Sixth Street, Brooklyn, NY, 11215, USA

    Paul H. McClelland, Krystyna Kabata, Antalya Jano, Michael E. Zenilman & Piotr Gorecki

  2. Department of Pediatric Surgery, Jagiellonian University Medical College, University Children’s Hospital of Krakow, Krakow, Poland

    Wojciech Gorecki

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Dr. Paul H. McClelland, Dr. Wojciech Gorecki, Dr. Michael E. Zenilman, and Dr. Piotr Gorecki have no conflicts of interest or financial ties to disclose. PA Krystyna Kabata and Antalya Jano also have no conflicts of interest or financial ties to disclose.

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464_2022_9434_MOESM1_ESM.eps

Supplementary file1 (EPS 364 KB) Supplemental Figure 1a Weight loss curves for patients undergoing LRYGB, LAGB, and LSG, measured by absolute weight. Individual points represent single patient weights and diamonds/bars represent means ± SD

464_2022_9434_MOESM2_ESM.eps

Supplementary file2 (EPS 364 KB) Supplemental Figure 1b Weight loss curves for patients undergoing LRYGB, LAGB, and LSG, measured by BMI. Individual points represent single patient weights and diamonds/bars represent means ± SD.

464_2022_9434_MOESM3_ESM.eps

Supplementary file3 (EPS 365 KB) Supplemental Figure 1c Weight loss curves for patients undergoing LRYGB, LAGB, and LSG, measured by net BMI change from baseline. Individual points represent single patient weights and diamonds/bars represent means ± SD.

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McClelland, P.H., Kabata, K., Gorecki, W. et al. Long-term weight loss after bariatric procedures for morbidly obese adolescents and youth: a single-institution analysis with up to 19-year follow-up. Surg Endosc 37, 2224–2238 (2023). https://doi.org/10.1007/s00464-022-09434-0

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