Surgery Works on Obese Teens

Gastric bypass surgery an option for obese kids losing weight

(RxWiki News) When diet and exercise doesn't work, overweight teens have another option to help shed the extra pounds.

Losing weight through bypass surgery works just as well for teenagers as it does for adults, a recently published study has found.

In 93 percent of these teens, the body mass indexes (BMI), which are used to measure obesity, decreased by more than 50 percent; their BMIs decreased from 45.5 to 30.2 on average.

"Eat healthy and exercise often to lose weight."

Gastric bypass surgery had been mostly done on adults and few had been done in the past on children and adolescents.

The study, led by Torsten Olbers, MD, senior physician and researcher at Sahlgrenska Academy in the Department of Surgery at the University of Gothenburg in Sweden, involved 81 teenagers with severe obesity between February 2006 and June 2009.

The 13- to 18-year-old teens had gastric bypass surgery, which makes the stomach smaller with minimal surgery, thus causing food to skip past the small intestine.

Another 162 adults and children were included in the study to compare to the first group of teens.

The adults also had the procedure. The second group of children, 43 percent of whom were boys, received conventional care.

"The teenagers who participated in the study represent a highly vulnerable group, with a history of psychosocial problems related to obesity, including bullying and underlying mental disease," Dr. Olbers said in a press release.

The teen participants received counseling and cognitive behavior therapy covering physical activity and their diet before being included in the study.

Those who were obese because of disease or had brain injuries were excluded.

Experienced surgeons at Sahlgrenska University Hospital did the surgeries.

Researchers tracked patients two, three and six months after surgery. More follow-up appointments happened one year and two years later.

Patients answered a health survey asking them about their quality of life on a scale from 0 to 100. Higher scores meant patients had better health.

At the two year follow-up, researchers found that the teenagers had lost almost 100 pounds on average after the surgery.

The BMIs of the kids with conservative treatment didn't change.

The teens also reported feeling better about themselves, both physically and mentally.

After the procedure, 12 teens needed additional surgery to fix complications, including gallstones, adhesions, hernias, volvulus (twisting of the intestines) and other abdominal pain.

Several other teens continued to have problems with bullying, depression, drug abuse and self-destructive behavior. Two attempted to kill themselves.

In addition, insulin levels and other risk factors for cardiovascular disease had significantly improved.

"Moreover, we know from earlier studies that teenagers with severe obesity are at risk of developing other diseases and poorer quality of life as adults," Dr. Olbers said.

"For that reason, we hope that the method can eventually be offered to more teenagers."

He said that future studies would look into possible adverse effects in teenagers from the surgery.

The authors said that the surgery does not impact children's mental distress right away. Teenagers can continue to have difficulty, even though they lost weight.

The authors, who declare no conflicts of interest, note that the study isn't random. But by controlling who was in it, the study could be performed safely and effectively.

The study was published September 25 in the International Journal of Obesity.

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Review Date: 
October 27, 2012