Health Gain vs Weight Loss After Teen Bariatric Surgery

Looking back, treating obesity has often been framed in terms of weight loss. But looking forward, we see much more emphasis on health gain. This is certainly evident in the new Canadian obesity treatment guidelines. A new analysis from the Teen LABS study gives us further reason to look beyond weight loss in bariatric surgery. Researchers found the same health benefits in teens who lost little weight compared to those who lost much more.

Principal investigator Thomas Inge explained:

“In looking at the relationship between the extent of weight loss and health benefits obtained, it is clear that patients’ health improves regardless of whether or not they sustain high levels of weight loss long-term following surgery.”

20 Percent Weight Loss – More or Less

In this analysis, the dividing line between high responders and low responders was 20 percent loss of a person’s starting weight – maintained after five years. The average weight loss for a teen in the low-responder group was 8.6 percent of initial weight five years after bariatric surgery. For the high-responder group, the reduction after five years was 33.8 percent. Most of the weight loss for both groups came in the first year. The key difference, though, was that low-responders had much more weight regain in subsequent years.

The striking finding here is that health benefits in both groups were mostly similar, despite the big differences in weight responses. The notable exception is blood lipids. High responders had better improvements in overall scores for dyslipidemia. On every other obesity-related health measure, there was no difference. Both groups benefited with better health five years after surgery.


About 60 percent of subjects in this study had lost more than 20 percent of their starting weight after five years. So that means that four out of ten had more modest results. If a person undertakes surgery expecting massive weight loss as the primary benefit, this could well be disappointing. Even more troubling is the partial regain of weight that is quite common.

However, this study reminds us that the best reason for undertaking bariatric surgery as a teen is to gain health. For instance, the remission of type 2 diabetes after five years was 75 percent – regardless of whether a person maintained a little or a lot of weight loss.

Of course, ongoing research will tell us more about longer term outcomes. Because good health is a lifelong pursuit. And for a teen with serious obesity, these data suggest that bariatric surgery can provide a significant head start on that.

Click here for the study, here and here for further perspective.

Friendship, painting by Mikalojus Konstantinas Čiurlionis / WikiArt

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December 6, 2020