Study Offers Weight Loss Surgery Options for Obese Adolescents

With teen obesity on the rise, weight loss experts have begun recommending weight loss surgery. Options for younger patients have been somewhat limited due to lack of research.  Lap band surgery is one of the lowest risk and least invasive weight loss surgery options. Here, Dr. Christine Ren-Fielding and colleagues studied a group of adolescent lap band surgery patients.

Study Design

This study was an FDA-approved trial of lap band surgery for adolescents aged 14 to 17.  Each met the NIH criteria for morbid obesity, having a BMI greater than 40. Each also had a history of obesity for more than five years and had failed to lose weight under medical supervision.  To ensure emotional readiness and maturity, patients met with psychologists or psychiatrists.  In addition, all patients demonstrated a willingness to follow the study protocol requirements.

Before and After Lap Band Surgery

Each patient underwent a physical examination before surgery, noting BMI and blood pressure.  The medical team also performed an electrocardiogram and urinalysis.  Patients then underwent thorough clinical analysis.  For example, the medical team administered thyroid, lipid, hemoglobin, and nutritional panels. The researchers compared this benchmark data to that collected for each patient one and two years post surgery.

Patients followed up with their medical teams once per month after lap band surgery.  The doctors noted changes to weight, appetite, and eating behaviors.  In addition, they noted unwanted symptoms such as difficulty swallowing and food intolerance.  The doctors adjusted the band based on their observations.

Study Results

The 54 patients included in the study underwent surgery between June 2005 and January 2007.  During the study, five patients withdrew and one patient did not qualify at the time of surgery due to inadequate physical maturity.  The researchers also disqualified three patients who did not follow the post-surgery guidelines.

In total, 45 patients had follow-ups after one year.  In this group, there were 30 females and 15 males.  41 patients total completed follow-ups after two years.  The findings by Dr. Christine Ren-Fielding and colleagues were positive:

• For these groups, the patients experienced an average of 31% excess weight loss at the 6 month mark.  This corresponded to an average BMI of 40.2.
• At one year, the average excess weight loss rose to 46% and the average BMI dropped to 36.3.
• Two years after bariatric surgery, the average excess weight loss was 47% and average BMI was 35.8.
• Average hip and waist circumferences were much lower one and two years after bariatric surgery.
• Patients lost both fat mass and lean mass, but the loss of fat mass was more substantial.
• All patients demonstrated an age-appropriate increase in bone density.
• Many patients also experienced resolution of their obesity-related health issues.

Conclusions

Lap band surgery has excellent outcomes for adolescents struggling with obesity.  The patients in the study experienced sustained weight loss two years after bariatric surgery.  In addition, they experienced overall better health after surgery.  Weight-related health issues improved significantly. In considering weight loss surgery options for adolescents, these data push lap band surgery to the forefront. Dr. Christine Ren-Fielding concluded that this bariatric surgery is a safe and effective option for this patient group.  It is minimally invasive and one of the lowest risk weight loss surgery options, too.

Bariatric Surgery Consultations with Dr. Christine Ren-Fielding

Are you are considering bariatric surgery? Interested in learning what your weight loss surgery options are?  Please contact Dr. Christine Ren-Fielding at the NYU Langone Weight Management Program.