Adolescent Bariatric Surgery Outcomes at 3 Years

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A prospective study (TH Inge et al. NEJM 2016; 374: 113-23) with 242 adolescents from five U.S. centers provides data on outcomes at 3 years. Here’s the scoop:

  • At baseline, mean age was 17 years, 75% were female, 72% were white, and mean BMI was 53.

At 3 years:

  • Mean weight decreased 27% (similar results for gastric bypass and gastric sleeve)
  • 95% had remission of type 2 diabetes (of those with diabetes at baseline)
  • 86% had remission in abnormal kidney function (of those with diabetes at baseline)
  • 74% had remission in elevated blood pressure (of those with diabetes at baseline)

lonnnngg Table 4 details the serious complications:

  • 13% of the participants (n=30, 47 procedures) had undergone additional abdominal procedures. While most of these were related to the procedure, a good number may have occurred regardlessly (eg. 18 cholecystectomies, 2 appendectomies)
  • 13% (n=29) also underwent endoscopic procedures including 9 who needed stricture dilatation.

The most common nutrient deficiency at followup was iron deficiency.  57% had low ferritin levels at 3 years compared with 5% at baseline.  Vitamin B12 deficiency was common; it declined by 35% and 8% had a deficiency at 3 years.  Vitamin A deficiencies increased (16% at 3 years). My take: this study documents the durability of weight loss and its beneficial effects on a multitude of problems.  It also shows that careful followup is needed for nutrient deficiencies and the risks of adverse events. Related blog posts:

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  1. Pingback: Bariatric Surgery and Reversal of NASH | gutsandgrowth

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