Effect of Ethnicity on Weight Loss Among Adolescents 1 Year After Bariatric Surgery
Sarah E. Messiah, Gabriela Lopez-Mitnik, David Winegar, Basem Sherif, Kristopher L. Arheart, Kirk W. Reichard, Marc P. Michalsky, Steven E. Lipshultz, Tracie L. Miller, Alan S. Livingstone, Nestor de la Cruz-Muñoz
- One year after surgery, Hispanic, Black and White teenagers lost nearly the same amount of weight, about 33 to 34 kg.
- No ethnic group had significantly better weight loss than another, and results were similar for boys and girls.
- The study drew on a national database covering 360 US facilities.
- The results support offering bariatric surgery to all adolescents with severe obesity who meet the criteria, regardless of background.
Using the national Bariatric Outcomes Longitudinal Database (BOLD), with data from 423 surgeons at 360 US facilities from 2004 to 2010, this study examined whether weight loss after bariatric surgery differs by ethnicity among 827 adolescents aged 11 to 19 who had gastric bypass or adjustable gastric banding. One year after surgery, mean weight loss was 34.3 kg in Hispanic, 33.8 kg in non-Hispanic Black and 32.8 kg in non-Hispanic White adolescents, a difference of no more than 1.5 kg. No ethnic group had better weight loss than another, supporting bariatric surgery as a reasonable treatment for all severely obese adolescents with appropriate indications.
Why This Study Was Needed
Hispanic and Black teenagers have the highest rates of severe obesity in the United States. Adult studies had suggested that weight loss after surgery might differ by ethnicity, which raised the question of whether surgery works equally well for teens of every background.
How the Study Was Done
The team used the national Bariatric Outcomes Longitudinal Database (BOLD), which collected data from 423 surgeons at 360 US facilities between 2004 and 2010. It included 827 adolescents aged 11 to 19 who had gastric bypass (51%) or an adjustable gastric band (49%), with weight measured at 3, 6 and 12 months.
What the Study Found
- One year after surgery, average weight loss was 34.3 kg in Hispanic teens, 33.8 kg in Black teens and 32.8 kg in White teens.
- The largest difference between groups was only 1.5 kg.
- No ethnic group did significantly better than another, and results were similar by gender.
What This Means for Teens and Families
Bariatric surgery works for teenagers of every background. Ethnicity should never be a reason to delay or discourage referral for a teen with severe adolescent obesity. Families can start with Am I a Candidate?.
Clinical Pearls
- One-year weight loss after adolescent bariatric surgery was nearly identical across ethnic groups.
- Results support equal access to surgery for all eligible teens.
Strengths and Limitations
The national, multi-center dataset strengthens generalizability. Follow-up decreased over time (247 patients at 12 months), and the study included gastric bypass and banding but not sleeve gastrectomy, which is now the most common adolescent operation.
Expert Commentary
Adult studies had found differences between ethnic groups, and I wanted to know whether that held true for teenagers. In a national sample, it did not. Every group did well. That is an important message for families and pediatricians in communities like ours.
— Dr. Nestor de la Cruz-Muñoz
Related Research
Messiah SE, Lopez-Mitnik G, Winegar D, Sherif B, Arheart KL, Reichard KW, Michalsky MP, Lipshultz SE, Miller TL, Livingstone AS, de la Cruz-Muñoz N. Effect of Ethnicity on Weight Loss Among Adolescents 1 Year After Bariatric Surgery. World Journal of Diabetes. 2013;4(5):202-209. doi:10.4239/wjd.v4.i5.202. PMID: 24147204.
