Nav: Home

Weight loss surgery offers new hope to children and adolescents with Prader-Willi Syndrome

September 28, 2015

New York, NY, September 28, 2015 -Obesity is a leading cause of complications and death in children suffering from Prader-Willi syndrome (PWS), yet there are few effective treatment options for these patients. In a new study published in Surgery for Obesity and Related Disease researchers found that bariatric surgery, specifically laparoscopic sleeve gastrectomy (LSG), resulted in substantial weight loss with no apparent adverse effect on growth in a small group of severely overweight patients with PWS. While bariatric surgery is considered controversial for PWS, the research team is encouraged by their positive results.

PWS is a rare genetic condition that causes a wide range of problems including a constant desire to consume food, which is driven by a permanent feeling of hunger. This can easily lead to dangerous weight gain, and in fact, in PWS obesity is a leading cause of death and related problems such as obstructive sleep apnea, dyslipidemia (abnormally high cholesterol or fats in the blood), hypertension, and diabetes mellitus.

"Questions are raised regarding the safety of bariatric surgery in PWS patients, the degree and sustainability of weight loss and resolution of related health problems, long term results, as well as the effect on growth and skeletal maturity. These concerns stem from the fact that the pathophysiology of obesity in those patients is unique and differs from what is observed in the general population," explained lead investigator Aayed R. Alqahtani, MD, RCSCS, FACS, of the Department of Surgery at King Saud University College of Medicine, Riyadh, Saudi Arabia.

The study was carried out at King Saud University College of Medicine, which is an academic center with a standardized care pathway for pediatric bariatric surgery. Dr. Alqahtani and co-investigators examined weight loss and growth after LSG in 24 children and adolescents with PWS aged between five and 18 years old and compared the results with patients without the syndrome, who were matched for age, gender, and body mass index (BMI).

"Our study indicates that bariatric surgery should be recommended for pediatric PWS patients; our results are unmatched by any other treatment. All of our patients experienced significant weight loss following LSG. There were no deaths or major complications, no significant morbidity, and no slowing of growth," reported Dr. Alqahtani. "Most of the weight loss occurred within the first two years after surgery and patients successfully reduced food intake and felt satiated by smaller amounts of food due to reduced stomach capacity." Data for up to five years follow-up were analyzed, during which time few complications occurred.

The PWS patients had a mean BMI of 46.2 (± 12.2) before surgery. All PWS patients had obstructive sleep apnea, 62% had dyslipidemia, 43% had hypertension, and 29% had diabetes mellitus. The change in BMI at the first, second, third, fourth and fifth annual visits was -14.7 (22 patients), -15.0 (18 patients), -12.2 (13 patients), -12.7 (11 patients), and -10.7 (7 patients), in the PWS group; while the non-PWS group had a BMI change of -15.9 (67 patients), -18.0 (50 patients), -18.4 (47 patients), -18.9 (26 patients), and -19.0 (20 patients), respectively.

Others may have a somewhat different take on the interpretation of these results. "Although the use of surgery in pre-adolescents with special needs is uncharted territory, the results are of interest, particularly since there has been very limited experience with modern bariatric procedures in this patient population," commented Dr. Thomas Inge, professor of surgery and pediatrics from Cincinnati Children's Hospital Medical Center. "While it is clearly not possible to make treatment recommendations for use of surgery in this complex population without further research to examine the physiologic impact, these initial findings should at least prompt a new conversation about prospective and more comprehensive studies to examine safety and efficacy of modern weight loss procedures and newer medications in patients with PWS."

Elsevier Health Sciences

Related Obesity Articles:

Obesity is in the eye of the beholder
Doctors have a specific definition of what it means to be overweight or obese, but in the social world, gender, race and generation matter a lot for whether people are judged as 'thin enough' or 'too fat.'
Type 2 diabetes and obesity -- what do we really know?
Social and economic factors have led to a dramatic rise in type 2 diabetes and obesity around the world.
Three in 4 don't know obesity causes cancer
Three out of four (75 percent) people in the UK are unaware of the link between obesity and cancer, according to a new Cancer Research UK report published today.
Obesity on the rise in Indonesia
Obesity is on the rise in Indonesia, one of the largest studies of the double burden of malnutrition in children has revealed.
Obesity rates are not declining in US youth
A clear and significant increase in obesity continued from 1999 through 2014, according to an analysis of data on United States children and adolescents age 2 to 19 years.
How does the environment affect obesity?
Researchers will be examining how agricultural and food processing practices may affect brown fat activity directly or indirectly.
Obesity Day to highlight growing obesity epidemic in Europe
The growing obesity epidemic, which is predicted to affect more than half of all European citizens by 2030, will be the focus of European Obesity Day to be held on May 21.
Understanding obesity from the inside out
Researchers developed a new laboratory method that allowed them to identify GABA as a key player in the complex brain processes that control appetite and metabolism.
Epigenetic switch for obesity
Obesity can sometimes be shut down.
Immunological Aspects of Obesity
This FASEB Conference focuses on the interactions between obesity and immune cells, focusing in particular on how inflammation in various organs influences obesity and obesity-related complications.

Related Obesity Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Failure can feel lonely and final. But can we learn from failure, even reframe it, to feel more like a temporary setback? This hour, TED speakers on changing a crushing defeat into a stepping stone. Guests include entrepreneur Leticia Gasca, psychology professor Alison Ledgerwood, astronomer Phil Plait, former professional athlete Charly Haversat, and UPS training manager Jon Bowers.
Now Playing: Science for the People

#524 The Human Network
What does a network of humans look like and how does it work? How does information spread? How do decisions and opinions spread? What gets distorted as it moves through the network and why? This week we dig into the ins and outs of human networks with Matthew Jackson, Professor of Economics at Stanford University and author of the book "The Human Network: How Your Social Position Determines Your Power, Beliefs, and Behaviours".