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Preparation of a severely obese adolescent for significant and long-term weight loss: an illustrative case

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Abstract

For severely obese patients planning bariatric surgery, many surgeons advise pre-operative weight loss which can be difficult for some to achieve. We report a 16-year-old male who was referred for weight loss surgery in a very late stage of severe obesity with a weight and BMI of 310 kg and 93 kg/m2, respectively. He also suffered from obstructive sleep apnea and hypertension. To prepare him for laparoscopic gastric bypass, a strict pre-operative nutritional intervention with inpatient and outpatient phases was designed. He lost 22 kg pre-operatively and an additional 86 kg by 67 months post-operatively, representing a 35 % total reduction in BMI. This case illustrates the feasibility and value of a defined pre-operative dietary intervention to effectively manage the weight of an adolescent referred late in the progression of severe obesity.

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References

  1. Ochner CN, Dambkowski CL, Yeomans BL, Teixeira J, Xavier Pi-Sunyer F (2012) Pre bariatric surgery weight loss requirements and the effect of preoperative weight loss on postoperative outcome. Int J Obes (Lond) 36(11):1380–1387

    Article  CAS  Google Scholar 

  2. Aberle J, Freier A, Busch P, Mommsen N, Beil FU, Dannheim V, Mann O (2009) Treatment with sibutramine prior to Roux-en-Y gastric bypass leads to an improvement of metabolic parameters and to a reduction of liver size and operative time. Obes Surg 19(11):1504–1507

    Article  PubMed  Google Scholar 

  3. Liu RC, Sabnis AA, Forsyth C, Chand B (2005) The effects of acute preoperative weight loss on laparoscopic Roux-en-Y gastric bypass. Obes Surg 15(10):1396–1402

    Article  PubMed  Google Scholar 

  4. Fris RJ (2004) Preoperative low energy diet diminishes liver size. Obes Surg 14(9):1165–1170

    Article  PubMed  Google Scholar 

  5. Benotti PN, Still CD, Wood GC, Akmal Y, King H, El Arousy H, Dancea H, Gerhard GS, Petrick A, Strodel W (2009) Preoperative weight loss before bariatric surgery. Arch Surg 144(12):1150–1155

    Article  PubMed  Google Scholar 

  6. Still CD, Benotti P, Wood GC, Gerhard GS, Petrick A, Reed M, Strodel W (2007) Outcomes of preoperative weight loss in high-risk patients undergoing gastric bypass surgery. Arch Surg 142(10):994–998

    Article  PubMed  Google Scholar 

  7. Huerta S, Li Z, Anthony T, Livingston EH (2010) Feasibility of a supervised inpatient low-calorie diet program for massive weight loss prior to RYGB in superobese patients. Obes Surg 20(2):173–180

    Article  PubMed  Google Scholar 

  8. Sumithran P, Prendergast LA, Delbridge E, Purcell K, Shulkes A, Kriketos A, Proietto J (2011) Long-term persistence of hormonal adaptations to weight loss. N Engl J Med 365(17):1597–1604

    Article  PubMed  CAS  Google Scholar 

  9. Bose M, Machineni S, Oliván B, Teixeira J, McGinty JJ, Bawa B, Koshy N, Colarusso A, Laferrère B (2010) Superior appetite hormone profile after equivalent weight loss by gastric bypass compared to gastric banding. Obesity 18(6):1085–1091

    Article  PubMed  CAS  Google Scholar 

  10. Jeffreys RM, Hrovat K, Woo JG, Schmidt M, Inge TH, Xanthakos SA (2012) Dietary assessment of adolescents undergoing laparoscopic Roux-en-Y gastric bypass surgery: macro- and micronutrient, fiber, and supplement intake. Surg Obes Relat Dis 8(3):331–336

    Article  PubMed  Google Scholar 

  11. Inge TH, Jenkins TM, Zeller M, Dolan L, Daniels SR, Garcia VF, Brandt ML, Bean J, Gamm K, Xanthakos SA (2010) Baseline BMI is a strong predictor of nadir BMI after adolescent gastric bypass. J Pediatr 156(1):103–108 e101

    Article  PubMed  Google Scholar 

  12. Yanoff LB, Parikh SJ, Spitalnik A, Denkinger B, Sebring NG, Slaughter P, McHugh T, Remaley AT, Yanovski JA (2006) The prevalence of hypovitaminosis D and secondary hyperparathyroidism in obese Black Americans. Clin Endocrinol (Oxf) 64(5):523–529

    Article  CAS  Google Scholar 

  13. Haroon M, Fitzgerald O (2012) Vitamin D and its emerging role in immunopathology. Clin Rheumatol 31(2):199–202

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229-3039, USA

    Andrew J. Kruger, Kathleen B. Hrovat, Stavra A. Xanthakos & Thomas H. Inge

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  1. Andrew J. Kruger
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  2. Kathleen B. Hrovat
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  3. Stavra A. Xanthakos
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  4. Thomas H. Inge
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Correspondence to Andrew J. Kruger.

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Kruger, A.J., Hrovat, K.B., Xanthakos, S.A. et al. Preparation of a severely obese adolescent for significant and long-term weight loss: an illustrative case. Pediatr Surg Int 29, 835–839 (2013). https://doi.org/10.1007/s00383-013-3311-y

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  • DOI: https://doi.org/10.1007/s00383-013-3311-y

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