Is Adolescent Gastric-Restrictive Antiobesity Surgery Warranted?
BACKGROUND: There is a paucity of information about adolescent morbid obesity and bariatric surgery. METHODS: We interviewed 78% of an adolescent (</=years) bariatric surgical population who had a vertical banded gastroplasty between 3 and 120 months previously. There were three males (M) and 11 females (F). History of obesity, post-operative change in diet, time spent exercising, weight change and subjective impressions were addressed. RESULTS: Males weighed more pre-operatively, lost more weight post-operatively and took longer to lose it than females. (Pre-op BMI: M = 59 +/- 2 vs F = 45 +/- 1; p </= 0.001. Months to lowest weight post-surgery: M = 37 17 vs F = 13 +/- 4; p </= 0.05. Post-operative BMI: M 35 +/- 5 vs F 33 3NS). Length of follow-up(years) was similar (M = 7+/-0.5 vs F = 4.1 +/- 1 NS). Both groups increased the amount of exercise following surgery. (Exercise minutes per week: M = Pre-op 13 +/- 13 vs Post-op 245 +/- 126 NS; F = Pre-op 18 +/- 16 vs Post-op 147 +/- 48; p </= 0.05). Males eat more than females (total K calorie per day: M = 4309 +/- 1677 vs F = 2324 +/- 417 NS). However, both groups have a high-fat diet (fat as per cent of total diet: M = 45 +/- 2 vs F = 42 +/- 3). The 13/14 patients who lost Weight support the concept of bariatric surgery being offered to an adolescent population. We ascribe the acceptable weight loss to the decrease in food intake, coupled with a major increase in physical activity. CONCLUSION: These data indicate that the adolescent morbidly obese population may be offered the same gastric-restrictive antiobesity therapy as adults, albeit with intensive dietary counseling.
Greenstein
RJ
Department of Surgery, The Mount Sinai School of Medicine, CUNY, New York, NY, 10468, USA.
Rabner
JG