Impressive 10-Year Outcomes for Metabolic Surgery in Teens

On the Boundary PathThe eternal question about medical and surgical treatment for obesity in young persons is all about long-term outcomes. Will the net effect of highly effective treatment actually be to make their lives better? An impressive new analysis of ten-year outcomes for metabolic surgery in teens offers excellent insight.

A Landmark Publication

The Teen-LABS (Longitudinal Assessment of Bariatric Surgery) study, a landmark analysis published in the New England Journal of Medicine, sheds light on the long-term effects of metabolic surgery for teenagers with severe obesity. Conducted over a decade, this study found that surgical intervention in adolescence not only facilitated significant and sustained weight loss but also greatly improved health markers such as diabetes control, blood pressure, and kidney function. These findings mark a critical shift in understanding how early surgical intervention can shape lifelong health outcomes for adolescents struggling with obesity-related health complications.

240 Teens into Adulthood

The study followed over 240 adolescents between the ages of 13 and 19, who underwent various types of metabolic surgery, including gastric bypass and gastric sleeve. Ten years post-surgery, participants maintained a substantial reduction in body weight and achieved remission in health conditions that are notoriously difficult to manage, such as type 2 diabetes and high blood pressure. Remarkably, 95% of teens with type 2 diabetes at baseline achieved remission following surgery—a rate higher than in adults undergoing similar procedures.

Another key insight from Teen-LABS is the relative benefit of early intervention. Adolescents showed greater long-term improvements compared to adults who delayed surgery until later in life, underscoring the importance of early surgical options for adolescents facing severe obesity. Despite the benefits, the study also highlighted certain risks, including an increased likelihood of requiring additional abdominal surgeries (often for issues like gallbladder removal) and higher rates of nutrient deficiencies, notably in iron and vitamin D. This emphasizes the need for long-term medical monitoring and support, such as supplementation and follow-up care, to address these risks.

Lead author Justin Ryder described the importance of these findings:

“Our study presents impressive outcomes of the longest follow-up of weight loss surgery during adolescence, which validates bariatric surgery as a safe and effective long-term obesity management strategy.”

Evidence for a Better Quality of Life

This work provides valuable data to help shape policy and guide medical professionals in making informed decisions about obesity treatments for adolescents. For families and young people grappling with the effects of severe obesity, Teen-LABS offers evidence of a viable option for reversing the trajectory of obesity-related health complications and improving quality of life. As the conversation about obesity in children and teens evolves, this impressive research brings to light the complex but potentially transformative role of metabolic surgery for youth.

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

On the Boundary Path, painting by Ilya Repin / WikiArt

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October 31, 2024

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