Bariatric surgery is safe for teens with morbid obesity

October 25, 2019

PHILADELPHIA -- Bariatric surgery is safe and, in many cases, beneficial for teenagers with morbid obesity who would otherwise face a heightened risk of developing severe health problems, including heart disease and stroke, according to a new study from Penn Medicine and the Children's Hospital of Philadelphia (CHOP). Researchers will present their findings on Sunday, October 27, at the American Academy of Pediatrics (AAP) 2019 National Conference & Exhibition in New Orleans.

"As the rate of childhood obesity continues to increase, it's critical for us to identify whether weight loss procedures that are frequently performed on adults are also safe and effective options for adolescents and teens," said the study's senior author Robert A. Swendiman, MD, MPP, MSCE, a sixth-year general surgery resident at Penn Medicine. "One component of that evaluation is balancing the risks of weight loss surgery against the prolonged exposure to severe health risks associated with obesity. Our findings show that the risks of undergoing bariatric surgery are quite low, suggesting that--for the right patients--surgery can serve as a safe and effective way to improve the health of these pre-teen and teenagers."

In the United States, there are nearly five million adolescents aged 10 to 17 with obesity, according to recent reports. Children with morbid or severe obesity--defined by a body mass index (BMI) at or above the 99th percentile for children of the same age and sex--have a higher risk of developing serious health conditions, including type 2 diabetes, high blood pressure and high cholesterol.

Less than one percent of children with morbid obesity undergo surgical weight loss procedures each year. To examine whether BMI or age was associated with an increased likelihood of being readmitted to the hospital within 30 days of surgery, or experiencing postoperative complications, the Penn team used a validated national database to study the incidence, outcomes and trends of adolescent bariatric surgery. They reviewed more than 3,700 cases involving patients aged 10 to 19 who underwent minimally invasive (laparoscopic or robotic) Roux-en-Y gastric bypass or sleeve gastrectomy, which involves removing part of the stomach to make it smaller.

Researchers found that the very few of the patients experienced complications (1.4 percent), readmissions (3.5 percent) or reoperations (1 percent). None of the patients died within 30 days of the surgery. They also observed a shift in the preferred surgical procedure, with the percentage of sleeve gastrectomy cases increasing from 74 percent in 2015 to 84 percent in 2017. Researchers attribute the shift, in part, to the higher rate of readmissions and complications experienced by patients who underwent Roux-en-Y gastric bypass, which involves creating a small pouch from the stomach and connecting it to the small intestine.

"We found no evidence that higher BMI was associated with an increased likelihood of poor health outcomes following adolescent bariatric surgery," Swendiman said. "In fact, our findings suggest that more readily referring patients with lower BMIs for surgery, rather than delaying consideration of surgery until adolescents develop worsening obesity, may prevent patients from suffering the severe health conditions associated with long-term obesity."
-end-
Gerard D. Hoeltzel, a research assistant at Penn and the first author, will present an abstract of the study from 8 a.m. to 9:15 a.m. on Oct. 27 at the Ernest N. Morial Convention Center, room 348-349.

Additional authors include Colleen Tewksbury, PhD, Matthew A. Goldshore, MD, PhD, Elizabeth Prout Parks, MD, Michael L. Nance, MD, and Kristoffel R. Dumon, MD.

Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $7.8 billion enterprise.

The Perelman School of Medicine has been ranked among the top medical schools in the United States for more than 20 years, according to U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $425 million awarded in the 2018 fiscal year.

The University of Pennsylvania Health System's patient care facilities include: the Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center--which are recognized as one of the nation's top "Honor Roll" hospitals by U.S. News & World Report--Chester County Hospital; Lancaster General Health; Penn Medicine Princeton Health; and Pennsylvania Hospital, the nation's first hospital, founded in 1751. Additional facilities and enterprises include Good Shepherd Penn Partners, Penn Home Care and Hospice Services, Lancaster Behavioral Health Hospital, and Princeton House Behavioral Health, among others.

Penn Medicine is powered by a talented and dedicated workforce of more than 40,000 people. The organization also has alliances with top community health systems across both Southeastern Pennsylvania and Southern New Jersey, creating more options for patients no matter where they live.

Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2018, Penn Medicine provided more than $525 million to benefit our community.

University of Pennsylvania School of Medicine

Related Obesity Articles from Brightsurf:

11 years of data add to the evidence for using testosterone therapy to treat obesity, including as an alternative to obesity surgery
New research covering 11 years of data presented at this year's European and International Congress on Obesity (ECOICO 2020) show that, in obese men suffering from hypogonadism (low testosterone), treatment with testosterone injections lowers their weight and improves a wide range of other metabolic parameters.

Overlap between immunology of COVID-19 and obesity could explain the increased risk of death in people living with obesity, and also older patients
Data presented in a special COVID-19 session at the European and International Congress on Obesity (ECOICO 2020) suggests that there are overlaps between the immunological disturbances found in both COVID-19 disease and patients with obesity, which could explain the increased disease severity and mortality risk faced by obese patients, and also elderly patients, who are infected by the SARS-CoV-2 virus that causes COVID-19 disease.

New obesity guideline: Address root causes as foundation of obesity management
besity management should focus on outcomes that patients consider to be important, not weight loss alone, and include a holistic approach that addresses the root causes of obesity, according to a new clinical practice guideline published in CMAJ (Canadian Medical Association Journal) http://www.cmaj.ca/lookup/doi/10.1503/cmaj.191707.

Changing the debate around obesity
The UK's National Health Service (NHS) needs to do more to address the ingrained stigma and discrimination faced by people with obesity, says a leading health psychologist.

Study links longer exposure to obesity and earlier development of obesity to increased risk of type 2 diabetes
Cumulative exposure to obesity could be at least as important as actually being obese in terms of risk of developing type 2 diabetes (T2D), concludes new research published in Diabetologia (the journal of the European Association for the Study of Diabetes [EASD]).

How much do obesity and addictions overlap?
A large analysis of personality studies has found that people with obesity behave somewhat like people with addictions to alcohol or drugs.

Should obesity be recognized as a disease?
With obesity now affecting almost a third (29%) of the population in England, and expected to rise to 35% by 2030, should we now recognize it as a disease?

Is obesity associated with risk of pediatric MS?
A single-center study of 453 children in Germany with multiple sclerosis (MS) investigated the association of obesity with pediatric MS risk and with the response of first-line therapy in children with MS.

Women with obesity prior to conception are more likely to have children with obesity
A systematic review and meta-analysis identified significantly increased odds of child obesity when mothers have obesity before conception, according to a study published June 11, 2019 in the open-access journal PLOS Medicine by Nicola Heslehurst of Newcastle University in the UK, and colleagues.

Obesity medicine association announces major updates to its adult obesity algorithm
The Obesity Medicine Association (OMA) announced the immediate availability of the 2019 OMA Adult Obesity Algorithm, with new information for clinicians including the relationship between Obesity and Cardiovascular Disease, Diabetes Mellitus, Dyslipidemia, and Cancer; information on investigational Anti-Obesity Pharmacotherapy; treatments for Lipodystrophy; and Pharmacokinetics and Obesity.

Read More: Obesity News and Obesity Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.