Large maternal weight loss from obesity surgery prevents transmission of obesity to children who were followed for 2 to 18 years.
OBJECTIVE
Our aim was to compare the prevalence of obesity in 172 children who were aged 2 to 18 years and born to 113 obese mothers (BMI: 31 +/- 9 kg/m2) with substantial weight loss after biliopancreatic bypass surgery with 45 same-age siblings who were born before maternal surgery (mothers' BMI: 48 +/- 8 kg/m2) and with current population standards.


METHODS
In this case series, with >88% follow-up in a tertiary referral center, cross sectional office chart and telephone data on childhood and adolescent weights were transformed to z scores.


RESULTS
After maternal surgery, the prevalence of obesity in the offspring decreased by 52% and severe obesity by 45.1%, with no increase in the prevalence of underweight. The z score reduction in obesity was gender specific, with boys reducing from 1.4 +/- 1.3 before to 0.57 +/- 1.7 after maternal surgery, corrected for birth order. The difference was not significant in girls (0.8 +/- 1.3 vs 0.8 +/- 1.2). Among children of both genders who were aged 6 to 18 years of age and born after maternal surgery, the prevalence of overweight was reduced to population levels.


CONCLUSIONS
Contrary to outcomes after intrauterine under- and overnutrition, the prevalence of overweight and obesity in children of mothers with large voluntary postsurgical weight loss was similar to that in the general population, with no increase in underweight. The results demonstrate the importance of potentially modifiable epigenetic factors in the cause of obesity.
Kral
John G
JG
Department of Surgery, Box 40, SUNY Downstate Medical Center, 450 Clarkson Ave, Brooklyn, NY 11203, USA. jkral@downstate.edu
Biron
Simon
S
Simard
Serge
S
Hould
Frédéric-Simon
FS
Lebel
Stéfane
S
Marceau
Simon
S
Marceau
Picard
P
D000293:Adolescent; D015904:Biliopancreatic Diversion; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009035:Mothers; D009765:Obesity / Q000517:prevention & control* / Q000601:surgery*; D013997:Time Factors; D015431:Weight Loss