Narrow Window to Reverse Teen Obesity With Surgery

According to a recent study of clinical characteristics of teens who underwent laparoscopic Roux-en-Y gastric bypass surgery from 2002 until 2007, doctors may have a much narrower window of opportunity to reverse morbid obesity in teens than previously thought. The study, conducted at Cincinnati Children’s Hospital Medical Center, appears online in the Journal of Pediatrics.

The study focused on 61 teens who underwent laparoscopic Roux-en-Y gastric bypass at Cincinnati Children’s. The results of the study showed that one year after the study, the body mass index in the overall group of teens pre-surgery decreased by 37%, however because of their starting weights, the teens were still considered to be morbidly obese. This means that doctors can predict what a patient’s weight will be one-year post weight loss surgery.

Lead author of the study, Thomas Inge, MD, PhD, an associate professor of surgery and pediatrics, explains that "Current guidelines for adolescent weight loss surgery suggest that we begin to consider surgery only after a teen is 80% to 100% overweight. Our new data show that when we intervene when a patient is between 100% and 150% over ideal weight, we can expect successfully resolution of obesity. But by the time the teen is 200% over their ideal weight for age, the surgery will reduce their weight substantially, but many of the patients will still remain morbidly obese.

This is the first study in adolescents to specifically show that the postoperative weight is strongly influenced by the patient’s starting weight. This finding raises a concern that waiting until children are super obese to begin to think of surgery may result in major weight loss, but not resolution of obesity and certain medical problems than intervening at an early stage of the disease. For instance, in those who remain significantly obese following surgery, this excess weight can have negative effects on joints and mobility; the long-term risks of remaining seriously overweight are unknown.

Inge says that the study indicates that families and communities need to take childhood weight problems seriously and aggressively pursue the best treatment options available for them before the weight problem gets out of hand. “As doctors who take care of kids, we have an obligation to identify those patients who are at highest risk and start explaining treatment options to families earlier before the child or teen gets to be two or three times his or her ideal weight, " says Inge.

Source: Cincinnati Children's Hospital Medical Center