1. Rosenberg, Karen


According to this study:


* Five years after gastric bypass, adolescents and adults had weight loss that was similar in magnitude.


* Remission of diabetes and hypertension occurred more often in adolescents than adults.



Article Content

The cumulative effects of sustained obesity raises the risk of comorbidities and complications. Bariatric surgery is most often performed in middle-aged adults. To determine if surgical intervention for severe obesity during adolescence is associated with a greater likelihood of remission of coexisting conditions, researchers compared the outcomes of gastric bypass in a cohort of obese adolescents with those of a cohort of adults who had sustained obesity since adolescence.


Baseline characteristics of the 161 adolescents and 396 adults included in the analysis were similar except that body mass index was higher in adolescents. Mean percent weight change wasn't significantly different in adolescents (-26%) and adults (-29%) five years after surgery. Sixty percent of adolescents and 76% of adults maintained a weight loss of 20% or more five years after surgery.


Adolescents were more likely than adults to have remission of type 2 diabetes (86% versus 53%) and hypertension (68% versus 41%). In the five years after surgery, three adolescents and seven adults died. The rate of subsequent intraabdominal procedures was higher in adolescents than in adults (19 versus 10 per 500 person-years); however, the percentage of people who underwent any subsequent intraabdominal procedure in the five years after gastric bypass was similar in the two cohorts. Ferritin levels were found to be low in more adolescents than adults, but the researchers note that ferritin level data were only available for both cohorts in the first two years following surgery.


The study was limited by low or infrequent counts for some outcomes and a lack of nonsurgical controls and long-term data on surgical or medical complications in adults (other than deaths and subsequent abdominal procedures).




Inge TH, et al. N Engl J Med 2019;380(22);2136-45.