Stomach surgery helps obese adolescents

WASHINGTON — Stomach surgery that curbs appetite and induces weight loss in adults shows similar benefits in obese adolescents, a new study finds. The teens also show improvements in key metabolic markers that serve as signposts for overall health, researchers reported June 11 at a meeting of the Endocrine Society. 

But while the markers improve dramatically during the first six months after surgery, benefits seem to reach a plateau during the second six months, the data also show.  

Although stomach surgery has led to weight loss and sometimes remarkable health improvements in obese adults (SN: 8/25/07, p. 115), it has not been broadly tested in teens.

In the new study, Ilene Fennoy and her colleagues monitored 24 very obese adolescents, average age 16, who had undergone laparoscopic banding surgery, in which an adjustable band is placed around the upper stomach. Banding makes a person feel full after eating less food. All the operations were performed by the same surgeon, reported Fennoy, a pediatric endocrinologist at Columbia University Medical Center. 

Before surgery, the children had an average body mass index of about 50. Someone with a BMI of 30 is typically considered overweight and a BMI of 35 signals obesity. Researchers monitored half the patients for a year and half for only six months.

Compared with measurements taken before surgery, the children had substantially lower BMI, levels of fats in the blood and C-reactive protein at the six-month point. C-reactive protein is a blood marker of inflammation that, when elevated, signals a heightened risk of heart disease. The adolescents also experienced drops in the upper (systolic) number on their blood pressure, but not the lower number, Fennoy said.

In the group monitored for a full year, the reductions in BMI, systolic blood pressure and C-reactive protein were maintained, but blood fats, known as triglycerides, largely reverted to pre-surgery levels. 

Although obesity predisposes a person to diabetes, heart disease and other ailments, surgery to combat it also seems to carry risks (SN:10/22/05, p. 260). “It’s a risk-benefit thing that you have to weigh,” says endocrinologist Ann Nardulli of the University of Illinois at Urbana-Champaign. “It will be really interesting to see how these kids fare later on.”

Many people in the medical community are waiting for more data on obesity surgeries, particularly regarding children, Nardulli says. “ ‘Do no harm’ is the mantra, yet you try to treat people so that they can have a fuller life. If this [surgery] is part of bringing them to that point, it could be quite useful.”