Obesity is a significant health issue among adolescents in the U.S., affecting about 1 in 5 teens. This condition is linked to an increased risk of developing serious health problems, including heart disease, type 2 diabetes, and certain cancers. While lifestyle changes, such as increased physical activity and dietary modifications, are typically the first approach to managing childhood obesity, they are not always effective. When these interventions fail, medications or weight-loss surgery, known as metabolic and bariatric surgery, may be considered. However, the long-term effects of weight-loss surgery on teens have not been well understood until now.
In 2007, a multi-center research group initiated an NIH-supported clinical study to assess the safety and effectiveness of weight-loss surgery in adolescents with severe obesity. Severe obesity in teens is defined as having a body mass index (BMI) of 35 or higher. The study involved 260 teens who underwent bariatric surgery at six clinical centers. Participants received either gastric bypass (161 teens) or sleeve gastrectomy (99 teens). The average age of the participants was 17, and the study collected health-related data before surgery and at various intervals over the next 10 years. The results were published in the New England Journal of Medicine in October 2024.
The findings of the study were promising. Overall, participants experienced a significant reduction in BMI within the first year after surgery, and this improvement was sustained over the next decade. The results were similar for both types of surgery, with an average 20% reduction in BMI after 10 years. Those who experienced greater weight loss in the first six months following surgery tended to maintain better long-term outcomes, with a more substantial decline in BMI.
Additionally, many health conditions that participants had prior to surgery were no longer present after 10 years. For example, 57% of those who had hypertension before surgery no longer had high blood pressure after a decade. Similarly, 54% of those with abnormal cholesterol levels (dyslipidemia) and 55% of those with type 2 diabetes saw their conditions resolve over the same period.
These results are especially noteworthy when compared to outcomes seen in adults undergoing weight-loss surgery. In a separate NIH-supported study of adults, only 18% of participants remained free of type 2 diabetes seven years after surgery, and only 13% remained diabetes-free after 12 years. The 55% reduction in type 2 diabetes in teens is a much better outcome, highlighting the potential benefits of addressing obesity early in life.
Dr. Justin R. Ryder, the first author of the study from Lurie Children’s Hospital of Chicago, emphasized the importance of treating obesity in adolescents. “Our study validates bariatric surgery as a safe and effective long-term obesity management strategy,” he said. “This is considerably better than the outcomes reported in adults, which underscores the value of addressing obesity in teens.”
Despite these promising findings, the researchers note that further studies are needed to compare the long-term health outcomes of weight-loss surgery versus weight loss medications for adolescents with severe obesity. These comparisons will help inform treatment decisions and ensure that the most effective strategies are available to manage obesity in teens.
In conclusion, the study provides strong evidence that weight-loss surgery can lead to significant, lasting health improvements in adolescents with severe obesity. The long-term benefits, including sustained weight loss and the resolution of obesity-related health conditions, make bariatric surgery a viable option for managing severe obesity in teens, especially when other interventions have not been successful.
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