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Study looks at weight loss surgery for teens

Participants in the study had to be at least 100 pounds over their ideal body weight to enter the program.
Credit: Courtesy University of Colorado hospital

A new study from Children’s Hospital Colorado compared obese adolescents who received traditional treatments for diabetes and obesity with those who received bariatric surgery.

Participants in the study had to be at least 100 pounds over their ideal body weight to enter the program. At the two year mark, the adolescents in the bariatric surgery group lost on average 97 pounds, decreased their body mass index by 28 percent, and 94 percent improved their hemoglobin A1c levels to non-diabetic ranges.

In comparison, those teens in the medical treatment group at two years experienced an average increase in body weight by 13 pounds, increase in body mass index by 3.5 percent and mean increase in their hemoglobin A1c levels from 6.3 percent to 7.6 percent.

The conclusions are surprising and potentially controversial. Lead study author Dr. Inge, who also serves as the Director of the Bariatric Surgery Center at Children's Hospital Colorado, has seen dramatic results for his severely obese adolescent patients who have had surgical procedures.

These adolescents are referred after failing to lose weight with nutrition counseling, exercise programs, psychological support, and behavioral interventions. There are two main types of bariatric (weight loss) surgery, the gastric sleeve and the Roux-en-Y procedure. Both decrease the size of the stomach and/or reroute the way in which food is digested by the stomach and small intestine. These procedures are done using laparoscopic techniques with small incisions.

This new study raises the question, with such dramatic results, is the surgical option a treatment that should be considered more often in an effort to reverse type 2 diabetes for severely obese adolescents?

Surgery does have its complications, and each procedure has its risks and benefits. Twenty-three percent of the adolescents in the bariatric surgery group had to go back to the operating room for additional surgical procedures.

Surgery, although potentially considered an extreme option, could be an important part of a comprehensive treatment plan for caring for adolescents who are obese.If surgery can reduce the severe complications that diabetes has on the body, such as future heart attacks, strokes, kidney issues, and amputations, then these minimally invasive procedures might significantly reduce healthcare costs and lead to better health and productivity for these teens. Future research, including following patients for longer time periods, will continue to provide answers to these questions.

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