Is Adolescent Gastric-Restrictive Antiobesity Surgery Warranted?

Background: There is a paucity of information about adolescent morbid obesity and bariatric surgery. Methods: We interviewed 78% of an adolescent (≤21 years) bariatric surgical population who had a vertical banded gastroplasty between 3 and 120 months previously. There were three males (M) and 11 females (F). History of obesity, post-operative change in diet, time spent exercising, weight change and subjective impressions were addressed. Results: Males weighed more pre-operatively, lost more weight post-operatively and took longer to lose it than females. (Pre-op BMI: M = 59 ± 2 vs F = 45 ± 1; p ≤ 0.001. Months to lowest weight post-surgery: M = 37 ± 17 vs F = 13 ± 4; p ≤ 0.05. Post-operative BMI: M = 35 ± 5 vs F = 33 ± 3 NS). Length of follow up (years) was similar (M = 7 ± 0.5 vs F = 4.1 ± 1 NS). Both groups Increased the amount of exercise following surgery. (Exercise minutes per week: M = Pre-op 13 ± 13 vs Post-op 245 ± 126 NS; F = Pre-op 18 ± 16 vs Post-op 147 ± 48; p ≤ 0.05). Males eat more than females (total K calorie per day: M = 4309 ± 1677 vs F - 2324 ± 417 NS). However, both groups have a high-fat diet (fat as per cent of total diet: M = 45 ± 2 vs F = 42 ± 3). The 13/14 patients who lost weight support the concept of bariatric surgery being offered to an adolescent population. We ascribe the acceptable weight loss to the decrease in food intake, coupled with a major increase in physical activity. Conclusion: These data indicate that the adolescent morbidly obese population may be offered the same gastric-restrictive antiobesity therapy as adults, albeit with intensive dietary counselling.