Early postoperative weight loss predicts long-term success of bariatric surgery in teens
Adolescents with obesity who lose at least 30% of excess weight in the 3 months after bariatric surgery are more likely to experience sustained, successful weight loss at 12 and 24 months, according to findings published in Pediatric Obesity.
In a retrospective chart review, Lisa Chu, PhD, a research fellow with the SickKids Team Obesity Management Program at The Hospital for Sick Children in Toronto, and colleagues analyzed data from 28 adolescents with obesity who underwent Roux-en-Y gastric bypass or sleeve gastrectomy between October 2010 and October 2017 (mean age, 17 years; 21 girls; mean BMI, 48.6 kg/m²; 70% white). Researchers assessed anthropometric measurements before and after surgery, with follow-up occurring at 3, 6, 12 and 24 months. Researchers calculated percent of excess weight loss using WHO growth chart standards to determine ideal weights based on height percentiles respective to age. The main weight-loss outcomes were change in weight and percent of excess weight loss at 12 and 24 months.
Within the cohort, percent of excess weight loss was 33.6% at 3 months, 55% at 12 months and 55.1% at 24 months.
Researchers found that percent of excess weight loss at 3 months was positively associated with percent of excess weight loss at 12 and 24 months (P < .05 for both). Receiver operating characteristic curve results indicated that patients who experienced at least 30% excess weight loss at 3 months would have successful weight loss, defined as at least 50% excess weight loss at 12 and 24 months. Patients with less than 30% excess weight loss at 3 months had a significantly lower percent of excess weight loss at 24 months, according to researchers, which was considered unsuccessful.
In repeated analysis of variance measures, researchers found that percent of excess weight loss at 3 months was different from the percent of excess weight loss at 6 months (P < .001) and 24 months (P = .001), but not between 12 and 24 months (P = 1), indicating a plateau in weight loss between 12 and 24 months after surgery.
“The ideal weight-loss target for adolescent patients following bariatric surgery remains unclear,” the researchers wrote. “Dietitians and clinicians are often concerned about bariatric surgery patients losing too much weight too fast within the early postoperative period. Therefore, these study results have clinical implications for clinical care of adolescents who undergo bariatric surgery.”
The researchers noted that interventions to help optimize early postoperative weight loss could include increased support group attendance and additional nutritional, exercise and psychological counseling. – by Regina Schaffer
Disclosures: The authors report no relevant financial disclosures.