New research that will be presented Sunday at the American Academy of Pediatrics (AAP) National Conference is endorsing bariatric surgery as a safe option for teenagers with obesity — and even for some younger patients.
Moreover, the surgery can be beneficial for these young patients, who might otherwise face the health risks associated with excessive weight, including premature death, according to the team of Penn Medicine and Children’s Hospital of Philadelphia researchers.
“Our study helps shed light on the safety of bariatric surgery, especially for young adolescents,” said presenting author Robert A. Swendiman, a surgeon at the Hospital of the University of Pennsylvania. “As clinicians, we must balance the risks of surgery vs. prolonged exposure to the ill effects of obesity in children.”
The researchers analyzed the cases of over 3,700 people between ages 10 to 19 who underwent either a minimally invasive Roux-en-Y gastric bypass or sleeve gastrectomy. In a sleeve gastrectomy, a portion of the stomach is removed. With a gastric bypass, the size of the stomach is also reduced, plus a part of the small intestine is closed off so that food bypasses it.
Bariatric surgery can improve overall health and quality of life and reduce the likelihood of premature death, and the rate of childhood obesity in the United States has tripled in the past 30 years. Yet, the authors said, bariatric surgery is still uncommon for young patients. For obese or morbidly obese youngsters, the rates of those who undergo bariatric surgery range from less than 1% to 2%.
Obesity is defined as a body mass index (BMI) of 30 or greater, while morbidly obese is defined as a BMI of 40 or higher. The average child studied was 18.5 years old with a BMI of 47, which would be the equivalent of a person with a height of 5-foot-5 who weighs 280 pounds.
The study’s authors did not find much medical basis for that hesitancy. Of the cases reviewed, in the first 30 days after surgery, only 1.4% experienced any complications, such as nausea or urinary tract infections, according to co-author and Penn research fellow Gerard Hoeltzel. One percent required additional surgery, and 3.5% had to be readmitted to the hospital. No deaths were reported.
The youngsters who had the surgeries had significant obesity-related health issues, including nearly 34% with hypertension, over 16% with obstructive sleep apnea, about 13% with gastroesophageal reflux disease, and close to 12% with diabetes.
Over 80% of the young people’s surgeries were sleeve gastrectomies, which the authors said have become the preferred type of bariatric surgery. Patients who had the gastrectomies were less likely to experience complications or require hospital readmission, the researchers said.