Presurgery health influences outcomes following vertical sleeve gastrectomy in adolescents

Abstract

ObjectiveWeight loss following vertical sleeve gastrectomy (VSG) in youth can range from 10% to 50%. We examined whether there are differences in demographic or metabolic parameters before VSG in youth who achieve above‐average weight loss (AAWL) versus below‐average weight loss (BAWL) at 1 year post VSG and if youth with BAWL still achieve metabolic health improvements at 1 year post VSG.MethodsDemographic, anthropometric, and clinical lab data were collected before VSG and at 1, 3, 6, and 12 months after VSG.ResultsForty‐three youth with a mean age of 16.9 (SD 1.7) years before VSG were studied; 70% were female, 19% non‐Hispanic Black, 58% non‐Hispanic White, and 23% mixed/other race. Mean baseline BMI was 51.1 (SD 10.5) kg/m2. Average weight loss was 25.8%. The AAWL group lost 18.6 kg/m2 (35.3%) versus the BAWL group, who lost 8.8 kg/m2 (17.5%). BMI, age, race, sex, and socioeconomic status at baseline were similar between AAWL and BAWL groups; however, the BAWL group had a higher frequency of pre‐VSG dysglycemia, steatotic liver disease, and dyslipidemia. At 1 year post VSG, fewer youth in the BAWL group achieved ideal health parameters, and they had less resolution of comorbidities.ConclusionsThe presence of comorbidities before VSG is associated with less weight loss and reduced resolution of metabolic conditions at 1 year post VSG.

Metabolic surgery: The sooner the better for long‐term success?

“…In this issue of Obesity, Swertfeger and colleagues focus on identifying preoperative markers of metabolic disease burden in adolescents undergoing sleeve gastrectomy and use that information to examine overall outcomes [2]. Dichotomizing patients into above average weight loss (AAWL) and below average weight loss (BAWL) groups, the authors use this grouping as a surrogate for responsiveness to MS. Swertfeger and colleagues demonstrate that adolescents with greater metabolic disease burden at the time of MS do not have as good a resolution of comorbid conditions when compared with adolescents with less severe obesity and fewer comorbid diseases.…”