Bariatric Surgery in Younger Versus Older Adolescents

Not long ago, bariatric surgery for adolescents with severe obesity was a rare consideration. Payers stubbornly resisted paying for it. Even for a 16-year old weighing more than 300 pounds, the very idea seemed “extreme” and off-putting. But now the American Academy of Pediatrics offers clear guidance. Surgery can be safe and effective for a young person with severe obesity. In fact, a new study tells us that even young teens do just as well as older teens. The authors of this study say:

“We found that younger and older adolescents had similar weight loss, resolution of hypertension and dyslipidemia, nutritional deficiencies, and improvement in quality of life after surgery. Age alone should not dissuade providers and patients from pursuing surgery when medically indicated.”

Long-Term Outcomes from Teen-LABS

These are data that come from a large study of this surgery in teens, sponsored by NIH. Teen-LABS is the work of six clinical centers and a data center. Researchers in this effort are doggedly pursuing a better understanding of severe obesity in youth and how it affects them over time. They are providing an invaluable evidence base for approaches to surgery in young people with obesity.

This new analysis compares five-year outcomes for teens between 13 and 15 years old to the outcomes for older teens. Both groups saw similar improvements in hypertension, blood lipids, and diabetes. The younger patients were less likely to show signs of vitamin D or iron deficiency.

Quality of Life

For both groups, quality of life improved within six months after surgery and remained improved over the five years of the study. The researchers found no difference between the younger and older patients. Faith Anne Newsome, who was not part of this study, had gastric bypass surgery when she was 16. She described the effect on her quality of life:

“Weight loss surgery changed my life. I am no longer the meek elementary school girl, embarrassed to tears by her weight. I have hope and I have a voice.”

Newsome is now working toward a PhD at the University of Florida. Her focus is obesity research. Last year, she received the Donald T. Lysle Service Award from the chancellor of the University of North Carolina at Chapel Hill. So you might say that the voice she has found is quite a significant one.

Progress toward better use of bariatric surgery for adolescents remains slow. But it is real. And it is heartening to see the impact it is having on the lives of young people.

Click here for the paper in Pediatrics and here for a guest commentary from Newsome for the STOP Obesity Alliance at George Washington University.

Reading, painting by Eastman Johnson / WikiArt

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February 5, 2021