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Obesity Surgery

, Volume 29, Issue 11, pp 3653–3664 | Cite as

Psychosocial Outcomes Following Adolescent Metabolic and Bariatric Surgery: a Systematic Review and Meta-Analysis

  • Spencer W. TrooboffEmail author
  • Ryland S. Stucke
  • Natalie BV Riblet
  • Anupama S. Kulkarni
  • Rupreet Anand
  • Ariana Casey
  • Marc A. Hofley
Original Contributions

Abstract

Background

Metabolic and bariatric surgery is an effective strategy to curb the natural history of obesity progression and improve psychosocial status in the short term for adolescents with severe obesity. The medium- and long-term psychosocial impact of bariatric surgery in this population is not established.

Methods

We searched MEDLINE (Ovid), EMBASE, Web of Science, PsycInfo, and the Cochrane Libraries through October 2017 for reports of weight loss surgery (roux-en-Y gastric bypass, sleeve gastrectomy, and adjustable gastric banding) on adolescents with severe obesity (age ≤ 21 years) having ≥ 6 months of follow-up. The primary outcome for inclusion in systematic review was use of a validated quality of life (QoL) or other psychosocial instrument at baseline and postoperatively. We used standardized mean difference (SMD) and random-effects modeling to provide summary estimates across different instruments.

Results

We reviewed 5155 studies, of which 20 studies met inclusion criteria for qualitative synthesis. There were 14 studies and 9 unique cohorts encompassing 573 patients which were eligible for meta-analysis regarding postoperative change in QoL. Across surgical procedures, there was significant improvement in QoL of 1.40 SMD (95% confidence interval 0.95 to 1.86; I2 = 89%; p < 0.001) at last follow-up (range 9–94 months). Trends in QoL improvement demonstrated the greatest improvement at 12 months; however, significant improvement was sustained at longest follow-up of 60+ months.

Conclusions

Weight loss surgery is associated with sustained improvement in QoL for adolescents with severe obesity across surgical procedures. Long-term data for psychosocial outcomes reflecting other mental health domains is lacking.

Keywords

Adolescent Bariatric surgery Psychosocial outcomes Quality-of-life 

Notes

Acknowledgments

We are thankful for and gratefully acknowledge the guidance of Marc P. Michalsky, MD, and Meg H. Zeller, PhD, in helping to define the criteria for our search strategy as well as with the interpretation and framing of our results.

Funding

This material is based upon work supported by the Office of Academic Affiliations, Department of Veterans Affairs.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Statement of Human and Animal Rights

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed Consent

For this type of study, formal consent is not required.

Supplementary material

11695_2019_4048_MOESM1_ESM.docx (240 kb)
Supplementary Appendix A (DOCX 15 kb)
11695_2019_4048_Fig6_ESM.png (402 kb)
Supplementary Appendix B

Funnel plot of effect size versus standard error for studies included in meta-analysis of change in quality of life at last follow-up (PNG 402 kb)

11695_2019_4048_MOESM2_ESM.tif (645 kb)
High resolution image (TIF 644 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of General Surgery, Dartmouth-Hitchcock Medical CenterLebanonUSA
  2. 2.VA Quality Scholars Program, Veterans Health AdministrationWhite River JunctionUSA
  3. 3.The Dartmouth Institute for Health Policy and Clinical PracticeLebanonUSA
  4. 4.Department of GastroenterologyDartmouth-Hitchcock Medical CenterLebanonUSA

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