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Bariatric surgery while young adults achieve lasting health benefits

Bariatric surgery among obese teens or young adults leads to a permanent reduction in body weight along with significant reductions in the rates of diabetes, high blood pressure and depression, according to new research in Journal of the American College of Surgeons.

The authors noted that approximately 12% of non-Hispanic blacks, 9% of Hispanics, and 7% of whites ages 12-19 are obese. Pediatrics. This paper defines obesity as having a body mass index of at least 35 kg/m2 or more, or equal to 120% of the 95th percentile for a person’s age and gender. For this population, the authors argue, lifestyle modification alone is unlikely to lead to better health.

Dr. Sarah Al Masih

“Telling people, ‘Oh, eat right and exercise more,’ obviously doesn’t work,” said lead researcher Sarah Messia, director of the UTSPH Center for Population Health for Children in Dallas, Texas. She added that this advice assumes that people know how to prepare healthy meals or exercise regularly in the first place, which is not always true.

“Live a normal life”

The ongoing study tracks the health outcomes of 96 people (83% female, 75% Hispanic) who had bariatric surgery by the time they turned 21 (median age, 19). Mean preoperative BMI was 44.7 kg/m2 – A character who is considered very fat. Participants’ average weight before surgery was 278.5 pounds, ranging from 241.5 to 324 pounds.

Study investigators followed patients’ health outcomes for at least 10 years and up to 18 years. Almost all patients (90%) underwent gastric bypass surgery, while the remainder underwent laparoscopic gastric banding.

Dr. Nestor de la Cruz Muñoz

Nestor de la Cruz Muñoz, MD, chief of bariatric surgery at the University of Miami Miller School of Medicine, and lead author of the study, completed all surgeries while working in a community clinic from 2002 to 2009. Cruz — Muñoz used a variety of methods to reconnect with patients after At least 10 years of their procedure, including calling or mailing patients to ask them to complete a telehealth visit. Of the 130 potential study participants, 96 agreed to participate in the research project.

At the telehealth visit, subjects reported their current weight, low weight, and current status of their other comorbidities such as diabetes or high blood pressure. Since Cruz-Muñoz was also interested in the impact of bariatric surgery on quality of life, he asked participants about the highest level of education completed, their relationship status, and whether they had children.

“I saw that they were leading a normal life,” Cruz Muñoz said. Some of them were university graduates, others were raising families. He remembers that at the time of the surgery, the young men were sad because they felt that their weight would forever deprive these possibilities.

In a 14-year follow-up, people who had gastric bypass surgery lost 31% of their highest weight, and those with a gastric band lost 22% of their highest weight, according to the researchers. In addition, all patients with preoperative hyperlipidemia (14.6%), asthma (10.4%) and diabetes (5.2%) reported complete recovery of these conditions (s < .05 per case). The researchers reported that their levels of anxiety and depression also decreased significantly.

A medical condition, not a character defect

“The study is important because it finally addresses what’s been going on for years and years,” said Kirk Richard, MD, MBA, director of the bariatric surgery program at Nemours Children’s Health, in Wilmington, Delaware. Richard was not part of this study, but he was lead author of a 2019 policy statement from the American Academy of Pediatrics that argued that bariatric surgery is safe and effective in obese children.

“Obesity is a medical condition, not a weakness of will or a character defect,” Richard said. “If someone has cancer, we don’t question their character, we treat cancer.” Richard said he advocated a similar non-judgmental approach to treating severe obesity, one that would involve a combination of bariatric surgery and prescribing GLP-1 agonists such as semaglutide (Ozempic).

The researchers did not report any relevant financial relationships.

GM Cool Surg. Published online September 15, 2022. Abstract

Marcus A. Banks is a New York City-based journalist who covers health news with a focus on new cancer research. His work appears in Medscape, Cancer Today, The Scientist, Gastroenterology & Endoscopy News, Slate, TCTMD and Spectrum.

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