Bright Morning

A Brighter View for Obesity Surgery in Teens

Two recent studies make it clear that a brighter view is emerging for obesity surgery in teens. First, in the Journal of the American College of Surgeons, Nestor de la Cruz-Muñoz and colleagues document good outcomes from bariatric surgery for adolescents over more than a decade. Second, Fereshteh Salimi-Jazi and colleagues provide a 15-year analysis of the utilization of surgical care for obesity in U.S. teens. The trends in their analysis are unmistakable. Teaching hospitals are embracing bariatric surgery for teens and it is reaching a more diverse population.

This is good news, though it’s also clear that this highly effective tool for severe obesity in young people remains underutilized.

Long-Term Follow-up via Telehealth

De la Cruz-Muñoz et al conducted a medical records analysis and telehealth visits with a sample of 96 young persons who ranged in age from 15 to 21 years when they had bariatric surgery. Their average age was 18.8 at the time of surgery and their median BMI was 44.7. They had their surgeries between 2002 and 2010. This was a time when the bar was very high for access to bariatric surgery in adolescents.

The telehealth visits for long-term follow-up came 10 to 18 years after their surgeries, assessing body weight, complications of obesity, social and physical functioning, and long-term complications. Even after all those years, they found weight reductions for these young people ranged from 23 percent for gastric band patients to 32 percent for gastric bypass patients. Among patients with high cholesterol, asthma, diabetes, or high blood sugar before surgery, researchers found a 100 percent rate of remission.

Other complications linked to obesity were greatly reduced – hypertension, sleep apnea, reflux disease, and depression. Senior author Sarah Messiah commented on the importance of these findings:

“There are long-term benefits to completing bariatric surgery before the age of 22. The durability of the positive health outcomes isn’t well known this far out at this young age. It’s been a gap in understanding that this research has helped fill.

“What sets this study apart is that 84 percent of the patients who underwent surgery are Hispanic or non-Hispanic Black. We know that minority groups are disproportionately impacted by obesity, and this shows that they benefited from the surgery, and thus surgery can be a tool to address these disparities.”

Messiah is a professor and director of the Center for Pediatric Population Health at UTHealth School of Public Health-Dallas.

Rising Utilization

The second study, published in Obesity Surgery, uses robust data from the National Inpatient Sample database. Looking at the utilization of bariatric surgery for adolescents between 2005 and 2019, Salimi-Jazi et al found that the number of cases more than doubled and it tripled for Hispanic youth. In 2005, White patients accounted for 75 percent of cases. By 2019, that number dropped to 53 percent. Sleeve gastrectomy emerged midway in this time frame and quickly became the dominant procedure – accounting for more than 80 percent of cases.

Despite all this growth in utilization, the authors point out that obesity surgery for teens remains “vastly under-considered and underutilized.” The fact is that many young people living with severe obesity grow into adulthood without any effective treatment for it. Quite succinctly, they sum up the importance of changing this:

“Decreasing the barrier to metabolic and bariatric surgery evaluation may be life-saving for children facing lifelong consequences of obesity.”

Click here for the De la Cruz-Muñoz study and here for an interview with the author. For the Salimi-Jazi study, click here.

Bright Morning (Watch Children), photograph by Ted Kyle

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September 23, 2022

One Response to “A Brighter View for Obesity Surgery in Teens”

  1. September 23, 2022 at 8:18 am, Allen Browne said:

    Ted,

    The kids thank you.

    Have a good day.

    Allen

    Reply

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