Background
Bariatric surgery is one of the few effective treatments for morbid obesity but the weight loss and other health related outcomes for this procedure in large, diverse adolescent patient populations are not well characterized.
Objective
To analyze the prospective Bariatric Outcomes Longitudinal Database (BOLD) to determine the weight loss and health related outcomes in adolescents.
Setting
BOLD data is collected from 423 surgeons at 360 facilities in the United States.
Methods
Main outcome measures included anthropometric and comorbidity status at baseline (n=890) and at 3 (n=786), 6 (n=541), and 12 (n=259) months after surgery. Adolescents (75% female; 68% non-Hispanic white, 14% Hispanic, 11% non-Hispanic black, and 6% other) age 11-to-19 years were included in the analyses.
Results
The overall one year mean weight loss for those who underwent gastric bypass surgery was more than twice that of those who underwent adjustable gastric band surgery (48.6 kg versus 20 kg, P<0.001). Similar results were found for all other anthropometric changes and comparisons over one year between surgery types (P<0.001). In general, gastric bypass patients reported more improvement versus adjustable gastric band patients in comorbidities one year after surgery. There were a total of 45 readmissions among gastric bypass patients and 10 among adjustable gastric band patients with 29 and 8 reoperations required, respectively.
Conclusions
Weight loss at 3-, 6-, and 12-months after surgery is approximately double in adolescent males and females who underwent gastric bypass surgery versus those who underwent adjustable gastric band surgery. Bariatric surgery can safely and substantially reduce weight and related comorbidities in morbidly obese adolescents for at least 1 year.
These results show that PASI 90-100 is a relevant therapeutic goal in moderate to severe psoriasis compared to PASI 75-89 when considering patients' QOL.
A greater proportion of patients achieved MDA with secukinumab versus placebo at week 16, with response rates sustained through 2 years. MDA was associated with improved PROs, including QoL, through 2 years.
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