NEW YORK, Oct. 30 (UPI) — Weight-loss surgery in adolescents with severe obesity can lead to long-term health benefits, such as more frequent remission of type 2 diabetes than in adults who undergo the same treatment, an 18-year, $29 million study funded by the National Institutes of Health has found.
The study was published Wednesday in the New England Journal of Medicine.
It’s important to learn about the value and risks of certain medications and surgical approaches because they show promise in helping teens with severe obesity, researchers said.
“These findings are essential as effective treatment options for severe pediatric obesity remain rare,” the study’s principal investigator, Dr. Thomas Inge, surgeon-in-chief at Lurie Children’s Hospital in Chicago, told UPI.
“Robust data on the outcomes of modern bariatric procedures are invaluable for clinicians and families considering ways to support adolescents facing obesity, especially in cases of rapid weight gain,” said Inge, who directs the hospital’s bariatric surgery program.
Between 2006 and 2012, the trial enrolled about 260 teens, ages 13 to 19. They underwent bariatric surgery at Cincinnati Children’s; Texas Children Hospital in Houston; Children’s Hospital of Alabama in Birmingham; University of Pittsburgh Medical Center; and Nationwide Children’s Hospital in Columbus, Ohio.
Young people with severe obesity who had bariatric surgery at age 19 or younger continued to experience sustained weight loss 10 years later. They also saw resolution of common obesity-related diseases, such as type 2 diabetes and high blood pressure and cholesterol, researchers reported.
Participants who had weight-loss surgery maintained these reductions in various obesity-related medical conditions: 20% in body mass index; 55% in type 2 diabetes; 57% in hypertension; and 54% in abnormal cholesterol.
Results were comparable between patients undergoing gastric bypass and sleeve gastrectomy.
The 55% decrease in type 2 diabetes was greater than the rates observed in adults after weight-loss surgery (18% at seven years and 12.7% at 12 years) in another recently published study funded by the National Institutes of Health.
With type 2 diabetes tending to progress more swiftly in young people, the current study’s findings prove the greater health benefits and long-lasting effects of bariatric surgery in youth than researchers would expect in adult counterparts.
“This study underscores that surgical treatment should be considered earlier in the course of severe obesity,” Inge said.
However, he noted that fewer than 1% of teens with severe obesity and eligible for surgery are able to receive successful treatments because of parental opposition for an assortment of reasons.
“We should advocate for early intervention and ensure that adolescents have access to effective therapies to mitigate the progression of obesity-related conditions, such as type 2 diabetes and hypertension,” said Inge, who also is a professor of surgery and pediatrics at Northwestern University Feinberg School of Medicine in Chicago.
Other pediatric weight-loss experts praised the researchers for advancing knowledge that will guide the treatment of adolescents with severe obesity.
“The rate of obesity continues to rise in children, threatening to impact future life expectancy and healthcare costs,” said Dr. Kirk Reichard, surgical director of the bariatric surgery program at Nemours Children’s Hospital in Wilmington, Del. He was not involved in the study.
“While efforts to address prevention are critical, the reality is that 20% of American children are now affected by obesity and need our help,” said Reichard, who also is clinical professor of surgery and pediatrics at Sidney Kimmel Medical College of Thomas Jefferson University in Philadelphia.
Dr. Andrea Coviello, an endocrinologist and director of the weight management program at the University of North Carolina School of Medicine in Chapel Hill, said “there has been a lack of long-term data on the benefits and risks of bariatric surgery in younger patients.”
Coviello added that “this study helps to fill in knowledge gaps that may help health care providers and parents to make informed decisions about health care options for children with obesity and obesity related conditions such as type 2 diabetes.”
Parents should seek advice from their pediatrician and pediatric weight-loss specialists if their children are overweight or obese, especially if they have obesity-related conditions, such as type 2 diabetes or high blood pressure. Coviello said.
“Appropriate care and weight loss earlier may significantly improve their child’s health in the longer term,” she said.
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