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Adolescent bariatric surgery

Ryan D Sheldon, Kayla M Kanosky, Kevin D Wells, Lili Miles, James W Perfield, Stavra Xanthakos, Thomas H Inge, R Scott Rector
BACKGROUND: Mechanisms responsible for progression of nonalcoholic fatty liver disease (NAFLD) to steatohepatitis (NASH) remain poorly defined. METHODS: To examine the potential contribution of adipose tissue to NAFLD progression, we performed a complete transcriptomic analysis using RNA-sequencing (RNA-seq) on intra-abdominal adipose tissue (IAT) from severely obese adolescents (Mage 16.9±0.4 yrs; BMI z-score 2.7±0.1) undergoing bariatric surgery and liver biopsy categorized into 3 groups; No steatosis (Normal, n=8), steatosis only (n=13), or NASH (n=10) by liver histology...
October 7, 2016: Physiological Genomics
Ramon Vilallonga, José Manuel Moreno Villares, Diego Yeste Fernández, Raquel Sánchez Santos, Felipe Casanueva Freijo, Francisco Santolaya Ochando, Nuria Leal Hernando, Albert Lecube Torelló, Luis Antonio Castaño González, Albert Feliu, Gontrand Lopez-Nava, Dolores Frutos, Antonio J Torres Garcia, Juan Carlos Ruiz de Adana
PURPOSE: In recent years, the incidence of childhood obesity in Europe, and Spain in particular, has increased dramatically. Bariatric surgery could play a major role in treating of adolescents with severe obesity. However, no specific guidelines for bariatric surgery currently exist in Spain. METHODS: The Board of the Spanish Society for Obesity Surgery and Metabolic Diseases (SECO) proposed a study of childhood obesity by using the Delphi method. This prospective study involved 60 experts from nine national societies...
October 17, 2016: Obesity Surgery
Raouf Amin, Narong Simakajornboon, Rhonda Szczesniak, Thomas Inge
BACKGROUND: Obstructive sleep apnea (OSA) associated with obesity is known to improve after bariatric surgery, but little is known about early changes in this condition after surgery. OBJECTIVES: To study the clinical course of OSA after bariatric surgery SETTING: Children's hospital in the United States METHODS: Adolescents and young adults with obstructive sleep apnea undergoing vertical sleeve gastrectomy (n = 6) or gastric bypass (n = 1) were enrolled in this prospective study...
May 30, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Givan F Paulus, Gerdy Konings, Nicole D Bouvy, L W Ernest van Heurn, Jan Willem Greve
BACKGROUND: Adolescent obesity is rapidly becoming more prevalent and is associated with chronic health conditions and psychosocial morbidity. Lifestyle intervention is often ineffective in morbidly obese adolescents, and bariatric surgery is gradually becoming an accepted treatment. However, little is known about long-term results. METHODS: Hospital charts of patients who had undergone gastric banding more than 5 years ago at an age of 18 years or younger, were retrospectively analyzed...
October 5, 2016: Obesity Facts
Melania Manco, Antonella Mosca, Francesco De Peppo, Romina Caccamo, Renato Cutrera, Ugo Giordano, Cristiano De Stefanis, Anna Alisi, Ulrich Baumann, Gianfranco Silecchia, Valerio Nobili
OBJECTIVE: To determine whether bariatric surgery is effective for the treatment of nonalcoholic steatohepatitis (NASH) in adolescence, we compared the efficacy of laparoscopic sleeve gastrectomy (LSG) with that of lifestyle intervention (nonsurgical weight loss [NSWL]) for NASH reversal in obese adolescents. STUDY DESIGN: Obese (body mass index ≥ 35 kg/m(2)) adolescents (13-17 years of age) with biopsy-proven NAFLD underwent LSG, lifestyle intervention plus intragastric weight loss devices (IGWLD), or only NSWL...
September 30, 2016: Journal of Pediatrics
Nicole Coles, Catherine Birken, Jill Hamilton
Severe obesity in childhood is increasing in prevalence and is associated with considerable morbidity. Studies into pediatric obesity have focused largely on interventions that do not necessarily target the unique biologic or psychological underpinnings for the weight gain in the individual child or adolescent. Outcomes show modest improvement and are of questionable benefit for patients with severe obesity. Although weight is a commonly used outcome, other psychological and metabolic parameters including normalization of physical activity and eating behaviors should be primary outcome goals...
September 29, 2016: BMJ: British Medical Journal
Megan J Cohen, Jennifer L Curran, Thao-Ly T Phan, Kirk Reichard, George A Datto
BACKGROUND: Noncompletion of preoperative bariatric programs is a significant problem among adolescents. Adult studies suggest that psychological factors contribute to noncompletion of preoperative bariatric programs. OBJECTIVE: The aim of this study was to determine the association between adolescent psychological functioning and completion of the preoperative phase of a bariatric program. SETTING: The study was conducted at a tertiary care children's hospital affiliated with a university medical center...
August 18, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Aslam Ejaz, Pankti Patel, Raquel Gonzalez-Heredia, Mark Holterman, Enrique F Elli, Robert Kanard
BACKGROUND: The increasing prevalence of obesity has necessitated the increasing use of bariatric surgery in the adolescent population. Outcomes following laparoscopic sleeve gastrectomy (LSG) among adolescents, however, have not been well-studied. We report outcomes following LSG as a first-line surgical therapy in patients under 21years of age. METHODS: All patients who underwent LSG as a primary surgical option for morbid obesity were identified at the University of Illinois at Chicago between 2006 and 2014...
September 3, 2016: Journal of Pediatric Surgery
Stacey Ishman, Christine Heubi, Todd Jenkins, Marc Michalsky, Narong Simakajornboon, Thomas Inge
OBJECTIVE: Obstructive sleep apnea (OSA) is reported in 70% of adolescents who present for bariatric surgery. The Pediatric Sleep Questionnaire (PSQ) was developed to identify children at risk for OSA but is not validated in adolescents with obesity. The aims of this study were: (1) to assess validity of the PSQ to detect OSA and (2) to determine the correlation between anthropometric and polysomnography measurements. METHODS: A cross-sectional assessment of Teen-Longitudinal Assessment of Bariatric Surgery participants at high risk for OSA was performed...
September 15, 2016: Obesity
Françoise Schmitt, Philippe Topart, Agnès Salle, Loïc Sentilhes, Natacha Bouhours-Nouet, Régis Coutant, Dominique Weil, Guillaume Podevin
We report here a case of a rarely described complication of laparoscopic adjustable gastric banding (LAGB), slippage during the postpartum period, after LAGB had been performed in an adolescent obese girl. The LAGB had been placed after one year of clinical survey initiated at the age of 16. Maximal pre-operative body mass index (BMI) was 48.5 kg.m(-2) and obesity was associated with insulin resistance. Before pregnancy, there was a loss of 17 Kg (final BMI = 41.5 kg.m(-2)) and a resolution of insulin resistance...
2016: Journal of Surgical Case Reports
Meg H Zeller, Gia A Washington, James E Mitchell, David B Sarwer, Jennifer Reiter-Purtill, Todd M Jenkins, Anita P Courcoulas, James L Peugh, Marc P Michalsky, Thomas H Inge
BACKGROUND: Problematic alcohol use and increased sensitivity postoperatively in adult weight loss surgery patients heightens concerns. No data have characterized these behaviors in adolescents-a gap, given adolescent alcohol use and heavy drinking are public health concerns. OBJECTIVE: To examine alcohol use behavior in adolescents who underwent weight loss surgery across the first two post-operative years in comparison to nonsurgical adolescents. SETTING: Five academic medical centers...
May 25, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Michael Holbach
BACKGROUND: Extreme obesity in adolescents is considered largely resistant to therapy. The aim of this study was to demonstrate the short- and long-term BMI histories of patients who have successfully participated in an inpatient weight loss program, and to look for factors influencing the very good success. METHODS: For the case series 10 youths were selected, who participated in an inpatient weight reduction program for 6-12 months and who succeeded in reducing BMI for the short and for the long term...
August 2016: MMW Fortschritte der Medizin
Stephanie Brandt, Diana König, Belinda Lennerz, Christina Schoosleitner, Alina Schäfer, Alena Siegfried, Wolfgang Siegfried, Martin Wabitsch
BACKGROUND: Extreme obesity in adolescents is considered largely resistant to therapy. The aim of this study was to demonstrate the short- and long-term BMI histories of patients who have successfully participated in an inpatient weight loss program, and to look for factors influencing the very good success. METHODS: For the case series 10 youths were selected, who participated in an inpatient weight reduction program for 6-12 months and who succeeded in reducing BMI for the short and for the long term...
August 2016: MMW Fortschritte der Medizin
Nirav K Desai, Mark L Wulkan, Thomas H Inge
Childhood obesity remains a significant public health issue. Approximately 8% of adolescent girls and 7% of adolescent boys have severe (≥class 2) obesity. Adolescent severe obesity is associated with numerous comorbidities, and persists into adulthood. Bariatric surgery is the most effective treatment available, resulting in major weight loss and resolution of important comorbid conditions. Clinical practice guidelines for pediatric obesity treatment recommend consideration of surgery after failure of behavioral approaches...
September 2016: Endocrinology and Metabolism Clinics of North America
Giovana D Maffazioli, Fatima Cody Stanford, Karen J Campoverde Reyes, Takara L Stanley, Vibha Singhal, Kathleen E Corey, Janey S Pratt, Miriam A Bredella, Madhusmita Misra
BACKGROUND: Obesity is prevalent among adolescents and is associated with serious health consequences. Roux-en-Y Gastric Bypass (RYGB) and Sleeve Gastrectomy (SG) are bariatric procedures that cause significant weight loss in adults and are increasingly being performed in adolescents with morbid obesity. Data comparing outcomes of RYGB vs. SG in this age-group are scarce. This study aims to compare short-term (1-6 months) and longer-term (7-18 months) body mass index (BMI) and biochemical outcomes following RYGB and SG in adolescents/young adults...
2016: Frontiers in Pediatrics
Justin R Ryder, Nicholas M Edwards, Resmi Gupta, Jane Khoury, Todd M Jenkins, Sharon Bout-Tabaku, Marc P Michalsky, Carroll M Harmon, Thomas H Inge, Aaron S Kelly
IMPORTANCE: Severe obesity is associated with mobility limitations and higher incidence of multijoint musculoskeletal pain. It is unknown whether substantial weight loss improves these important outcomes in adolescents with severe obesity. OBJECTIVE: To examine the association of bariatric surgery with functional mobility and musculoskeletal pain in adolescents with severe obesity up to 2 years after surgery. DESIGN, SETTING, AND PARTICIPANTS: The Teen-Longitudinal Assessment of Bariatric Surgery Study is a prospective, multicenter, observational study, which enrolled 242 adolescents (≤19 years of age) who were undergoing bariatric surgery from March 2007 through February 2012 at 5 US adolescent bariatric surgery centers...
September 1, 2016: JAMA Pediatrics
Lara Pizzorno
As discussed in Part 1, obesity is now a global epidemic affecting a significant and rapidly increasing number of adults, adolescents, and children. As the incidence of obesity has increased, so has the use of bariatric surgery to treat it. A growing number of recently published studies have reported that, despite calcium and vitamin D supplementation, the most frequently performed types of bariatric surgery, the Roux-en-Y gastric bypass (RYGB) and the sleeve gastrectomy (SG), cause significant, ongoing bone loss...
April 2016: Integrative Medicine
Neil Wright, Jerry Wales
Approximately 3% of children and adolescents in the UK have severe obesity. The incidence of cardiovascular risk factors such as hypertension, hyperinsulinism and hyperlipidaemia approaches 20% in such individuals. Lifestyle intervention programmes and pharmacotherapy are effective in some individuals, but the relapse rate is high. In exceptional cases, bariatric surgery is effective. This review outlines the scale of the problem, highlights those at risk and discusses referral, current services, appropriate screening and therapeutic interventions...
June 16, 2016: Archives of Disease in Childhood
Andrea M Stroud, Devin Parker, Daniel P Croitoru
PURPOSE: Although controversial, bariatric surgery is increasingly being performed in adolescents. We developed a model to simulate the effect of timing of gastric bypass in obese adolescents on quantity and quality of life. METHODS: A Markov state-transition model was constructed comparing two treatment strategies: gastric bypass surgery at age 16 versus delayed surgery in adulthood. The model simulated a hypothetical cohort of adolescents with body mass index of 45kg/m(2)...
May 2016: Journal of Pediatric Surgery
Amy S Shah, David D'Alessio, Martha E Ford-Adams, Ashish P Desai, Thomas H Inge
Type 2 diabetes, once referred to as "adult-onset" diabetes, has now emerged as a formidable threat to the health of obese adolescents. Although there is growing evidence regarding the epidemiology of type 2 diabetes in youth and its multisystem health consequences, treatment options have lagged and progression of disease occurs even with aggressive medical therapy. Increasing interest in the application of bariatric surgery for adolescents with type 2 diabetes has evolved in part because of the evidence demonstrating improvement or remission in many adults with diabetes after surgery...
June 2016: Diabetes Care
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