Changes in Weight and Comorbidities Among Adolescents Undergoing Bariatric Surgery: 1-Year Results from the Bariatric Outcomes Longitudinal Database

• In 890 adolescents from a national registry, gastric bypass produced 48.6 kg of weight loss at one year, more than twice the 20 kg lost after gastric banding.
• Gastric bypass patients generally reported greater improvement in obesity-related health conditions.
• Readmissions and reoperations occurred in a minority of patients and were more common after bypass.
• The study supported bariatric surgery as a safe and effective treatment for teenagers with severe obesity.

Why This Study Was Needed

By 2010, bariatric surgery was being offered to more adolescents, but outcomes in large, diverse groups of teens were not well described, and it was unclear how gastric bypass and gastric banding compared in this age group.

How the Study Was Done

The team analyzed the national Bariatric Outcomes Longitudinal Database (BOLD), drawing on 423 surgeons at 360 US facilities. The study included 890 adolescents aged 11 to 19 (75% female; 68% White, 14% Hispanic, 11% Black) who had gastric bypass or an adjustable gastric band, with weight and health conditions tracked at 3, 6 and 12 months.

What the Study Found

• At one year, gastric bypass patients lost 48.6 kg on average, compared with 20 kg after banding.
• Weight loss was roughly double after bypass at every time point, for both boys and girls.
• Bypass patients generally reported greater improvement in obesity-related conditions.
• There were 45 readmissions and 29 reoperations after bypass, and 10 readmissions and 8 reoperations after banding.

What This Means for Teens and Families

Surgery can safely produce major weight loss and health improvements in teenagers. The choice of operation matters a great deal: banding produced much less weight loss and is now rarely used in teens, while gastric bypass and sleeve gastrectomy are the main options today. Our 10- to 18-year follow-up shows that the benefits can last into adulthood. Start with Am I a Candidate?.

Clinical Pearls

• Gastric bypass produced more than twice the weight loss of banding in adolescents.
• Comorbidity improvement was greater after bypass.
• National data supported the safety of bariatric surgery in teens.

Strengths and Limitations

This was one of the largest early studies of adolescent bariatric surgery, drawn from hundreds of centers. Follow-up thinned by 12 months (259 patients), and the study predates widespread sleeve gastrectomy. Long-term data later came from studies such as Teen-LABS.

Expert Commentary

This national study helped settle an early debate about which operation to offer teenagers. The band was attractive because it seemed less invasive, but the weight loss was far smaller. Choosing an effective operation the first time spares young patients from needing revision later.

— Dr. Nestor de la Cruz-Muñoz

Related Research

• Effect of Ethnicity on Weight Loss Among Adolescents 1 Year After Bariatric Surgery
• Long-Term Outcomes After Adolescent Bariatric Surgery