One-Year Self-Reported Appetite Is Similar in Adolescents with Obesity Who Do or Do Not Undergo Sleeve Gastrectomy

Abstract

Background: With the growing prevalence of severe obesity in adolescents, sleeve gastrectomy (SG), a type of metabolic bariatric surgery (MBS), is increasingly being performed at a younger age. Data regarding changes in homeostatic and hedonic appetite following SG are conflicting in adults, with some studies showing no change and others showing a decrease in appetite. Data evaluating the effect of SG on appetite during adolescence, when appetite is more plastic, are currently lacking. Objective: To evaluate appetite changes one year after SG in adolescents with obesity vs. in non-surgical controls (NS). Methods: Thirty-nine subjects 13–21 years old with severe obesity were followed for a year; 19 underwent SG, and 20 were followed without surgery. Subjects had fasting blood tests for appetite-regulating hormones and completed a visual analog scale for appetite assessment (VAS). Results: The SG group had a decrease in body mass index (BMI) at one-year (baseline: 48.2 ± 1.7 kg/m2; one-year follow-up: 42.6 ± 1.0 kg/m2 (p ≤ 0.0001)). No within- or between-group differences were noted in the one-year change in appetite in the SG and NS groups. After SG, fasting ghrelin decreased (p ≤ 0.0001); however, no changes were noted in peptide YY (PYY) levels. Changes in one homeostatic appetite measure following SG were inversely associated with changes in fasting PYY (r = −0.583, p = 0.011). Appetite changes were not associated with weight loss or final BMI. Conclusions: There were no changes in appetite measures one-year after SG from pre-surgery levels in adolescents with obesity, and appetite changes were not associated with changes in BMI. It is important to evaluate the impact of long-term appetite changes, if any, on weight loss after SG.

Cirugía Metabólica (Manga Gástrica en Adolescencia: Indicaciones Y Contraindicaciones)

“…El uso de la MBS a edades más tempranas está aumentando debido a la mayor prevalencia de obesidad severa en la adolescencia y debido a la escasez de otras estrategias efectivas para perder peso en este grupo de edad. La gastrectomía en manga (SG) es la MBS más comúnmente empleada en adolescentes (15).…”

“…UU, el 7,5 % de los adolescentes de 12 a 15 años y el 9,5 % de los adolescentes de 16 a 19 años tienen obesidad grave con un índice de masa corporal (IMC) estimado ≥ 120 % del percentil 95 para su edad y sexo (14). Estos pacientes tienen mayor riesgo de desarrollar problemas de salud relacionados con la obesidad, como hipertensión, cardiopatía coronaria, diabetes tipo 2 e hiperlipidemia, lo que resulta en mayor morbilidad y mortalidad (15).…”

Ethics of Bariatric Surgery in Adolescence and Its Implications for Clinical Practice

“…Vertical sleeve gastrectomy (VSG) currently represents the most commonly performed procedure in this age group, given its safety, efficacy, and tolerability profile. Good results were reported regarding sustained weight loss, improvement or resolution of comorbidities, and compliance at follow-up [3,5,7,8]. It also has significant advantages in terms of metabolic effects compared to the other techniques [31].…”

“…In this context, BS gained growing attention as a treatment option for pediatric obesity and is currently performed at an increasing rate in severely obese adolescents who do not respond to conservative treatment [3,5,6]. Vertical sleeve gastrectomy (VSG) has become the most commonly used and recommended surgical procedure in this age group [7,8].…”

Ultraprocessed Foods and Obesity Risk: A Critical Review of Reported Mechanisms

“…Second, gastric emptying is not tightly correlated with appetitive sensations [ 317 ]. This is not surprising given that over time, individuals with partial [ 318 , 319 ] or complete [ 320 ] gastrectomy have normal appetitive sensations. It is clear that other systems contribute to appetitive sensations.…”