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Gastric bypass enables teens to maintain weight loss but may not be entirely safe

Two new studies looking at the long-term effects of bariatric surgery have found that adolescents fare as well as adults after undergoing the intervention in terms of their ability to maintain weight loss.
The studies followed teenagers and young adults who had Roux-en-Y gastric bypass surgery over the course of five to ten years and compared the amount of weight loss achieved and maintained over time.
This type of surgery is becoming more widespread due to rising rates of obesity and the inadequacy of standard weight loss advice. It has shown effectiveness in adults and more and more adolescents are asking for it.
But, data on the safety, outcomes and cost-effectiveness of adolescent bariatric surgery was lacking so far to justify it being indicated more often for teens.
These new studies, published in the Lancet, are providing some answers. They show, among other things important reductions in weight and an improvement of cardiovascular risks associated with being overweight up to five years after surgery.
In the first study, led by scientists of Cincinnati Children’s Hospital Medical Centre, young people aged 5 to 12 had a reduction in BMI of almost 30 per cent after eight years. Their blood pressure was significantly reduced and they had improved cholesterol levels.
The second study, conducted by researchers at the University of Gothenburg, showed that adolescent surgical patients of about the same age lost 36.8 kg over 5 years and had notable improvements in their cardiovascular risk factors.
As for the adverse outcomes associated with the surgery, two patients from the original study done by Cincinnati researchers died – one from infectious colitis, and the other from events deemed “unrelated to surgery” six years later.
Other complications and side effects were found, with half of the patients having anemia or vitamin (B12 and D) deficiencies in the Cincinnati study. In addition to that, 20 out of 81 adolescents in the Gothenburg cohort had to undergo additional abdominal surgical interventions for acute intestinal obstruction and gallstones.
Deficiencies in nutrient absorption are common with Roux-en-Y surgeries and can be potentially overcomen, but the other set of complications from the intervention itself are worrying.
Overall, bariatric surgery can be a helpful strategy for obese teenagers who are at risk for other conditions and need to lose weight rapidly. But, questions about the safety of the intervention or at what age it should be performed remain unanswered.

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