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Bariatric Surgery for Teens with Severe Obesity Study: Teen-LABS

The NIDDK funded the Teen-LABS (Longitudinal Assessment of Bariatric Surgery) study to look at the short- and long-term risks and benefits of bariatric (weight-loss) surgery in teens, including gastric band, gastric sleeve, and gastric bypass. Teen-LABS is the first large-scale study of this procedure in teens who have severe obesity (a much greater-than-normal amount of body fat) and serious weight-related health problems, such as prediabetes, type 2 diabetes, cardiovascular disease (heart and blood vessel disease), sleep apnea (breathing problems during sleep), nonalcoholic fatty liver disease (NASH), or other conditions.

For teens with severe obesity, lifestyle changes such as following a healthy eating plan for weight loss and being more active are important, but if not enough weight is lost to improve health, then additional treatments such as weight-loss surgery may be considered. Weight-loss surgery is being used more often as a treatment for teens who have severe obesity, but more research is needed in this area better understand how effective it is with teens and whether there are risks associated with the surgery.

Results

Researchers found major improvements in weight, heart health, prediabetes, type 2 diabetes, high blood pressure, high blood cholesterol, and abnormal kidney function 3 years after weight-loss surgery in teens who were in the study.

Five years after weight-loss surgery, researchers compared results for teens who were in the study and had gastric bypass surgery to adults who had the same procedure in the LABS (Longitudinal Assessment of Bariatric Surgery) study. Adults in the LABS study reported having obesity when they were teens but did not have surgery until they were adults. Researchers found that earlier gastric bypass surgery may have greater benefits compared to waiting until later in life.

  • Teens lost 26 percent of their bodyweight and adults lost 29 percent of their bodyweight.
  • Teens with type 2 diabetes before surgery were more likely than adults to have better blood glucose (blood sugar) control without the use of diabetes medications. After surgery no teens needed diabetes medications compared to 88 percent of teens before surgery. After surgery 26 percent of adults needed diabetes medications compared to 79 percent of adults before surgery.
  • Teens were more likely than adults to no longer have high blood pressure or take blood pressure medications. After surgery 11 percent of teens needed blood pressure medications compared to 57 percent of teens before surgery. After surgery 33 percent of adults needed blood pressure medications compared to 68 percent of adults before surgery.

Researchers also identified some risks from surgery. Five years after surgery teens were more likely than adults to need additional abdominal surgery, most commonly gallbladder removal. Teens were also more likely to have low iron and vitamin D levels, possibly because teens may be less likely to take enough vitamin D and mineral supplements after surgery. There was a similar death rate for teens and adults.

Study Size, Participant Demographics, Study Design, and Follow-up

About 240 teens, ages 13 to 19, were enrolled in Teen-LABS between 2006 and 2012. 161 teens in the study had bariatric surgery at five medical centers:

  • Cincinnati Children’s Hospital Medical Center, Ohio
  • Texas Children’s Hospital, Texas
  • Children’s Hospital of Alabama, Alabama
  • University of Pittsburgh Medical Center, Pennsylvania
  • Nationwide Children’s Hospital, Ohio

Before joining the study, all of the teens made the decision to have weight-loss surgery. While the study did not provide their surgeries, all surgeries took place at one of the Teen-LABS’ clinical locations specialized in the surgical evaluation and management of young people with severe obesity. Their health was then evaluated as part of the study before and after surgery. The surgeries were performed between 2007 and 2012.

In 2016, NIDDK extended funding for Teen-LABS for several more years to allow the researchers to gain additional information from participants on longer-term benefits and risks from the surgery. For example, researchers will assess

  • how long the weight loss lasts
  • whether improvements in quality of life, diabetes, blood pressure, and other conditions are long lasting
  • whether other health problems occur

Research findings on the longer-term health outcomes of weight-loss surgery will guide treatment decisions to improve the health of teens with severe obesity.

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