Weight loss surgery helps obese teens

Quality of life improves after operation RYGB cuts long-term health complications

NEW YORK, Nov 21, (RTRS): Obese teens who have surgery to lose weight report better quality of life, less joint pain and fewer physical limitations after their operations than before, a new study suggests.

Researchers followed 242 obese teens who had so-called metabolic and bariatric surgery to lose weight over three years, starting when they were 17 years old, on average. Prior to surgery, half of the teens had a body mass index (BMI) of at least 50, making them severely obese; two-thirds had musculoskeletal pain and joint pain and half had poor physical function.

Three years after surgery, the teens’ average reduction in BMI was 27%, which meant they were still obese. However, previous research has shown that a BMI reduction of just 5% to 10% is enough to result in meaningful improvements in health and quality of life.

And in the current study, researchers found that every 10% reduction in BMI was associated with 6% lower odds of the teens having musculoskeletal pain and 10% lower odds of having joint pain.

“Metabolic and bariatric surgery leads to large and sustained reductions in joint pain and improvements in physical function in adolescents with severe obesity over 3 years,” Dr Sharon Bout-Tabaku of Nationwide Children’s Hospital in Columbus, Ohio, and colleagues write in Pediatrics.

Activity

“These improvements will allow teenagers to move, be more functional, and participate in physical activity to improve their joint health and maintain their weight loss,” the study team notes.

More than one in five American teens are obese, according to the US Centers for Disease Control and Prevention (CDC). Teens are considered obese when their BMI is at or above the 95th percentile for youth of the same age and sex.

An online child and teen BMI calculator is available from the CDC.

Adolescent obesity is associated with chronic joint pain and with irreversible

NEW YORK, Nov 21, (RTRS): Three in four obese people with diabetes who had a common type of weightloss operation called Roux-en-Y gastric bypass (RYGB) experienced remission of their diabetes within a year after surgery, a Danish study found.

Five years later, 27 percent of the people who achieved remission had relapsed, the study also found. However, the total proportion of people in remission held steady, suggesting that some people achieved remission later and remained free of diabetes symptoms.

“We have known for some years from smaller studies . . . that Rouxen-Y gastric bypass surgery has the ability to make type 2 diabetes go into remission, meaning freeing patients from the use of glucose-lowering drugs,” said lead study author Dr Lene Ring Madsen of Aarhus University in Denmark.

“The novelty of our study is that we can confirm these results in large real-world cohorts of unselected patients with severe obesity and type 2 diabetes,” Madsen said by email.

Gastric bypass reduces the size of the stomach from about three pints to

joint damage, the researchers note. But even as a growing number of obese teens get metabolic and bariatric surgery to lose weight, research to date hasn’t offered a clear picture of how these operations impact future joint health.

In the current study, the decline in BMI wasn’t directly associated with changes in poor physical function three years after surgery.

But young people who complained of joint pain after the surgery were 21% more likely than those who didn’t to also report poor physical function.

The study wasn’t designed to prove

roughly the size of a shot glass.

In the current study, researchers examined data on 1,111 people with type 2 diabetes, the more common form that’s associated with obesity and aging. All the patients had Rouxen-y gastric bypass procedures between 2006 and 2015.

Patients were more likely to achieve diabetes remission after surgery when they were younger, had been living with diabetes for shorter periods of time, and had less severe diabetes. Men also did better than women.

Within six months of surgery, 65 percent of patients had their diabetes go into remission. This rate rose to 74 percent over the next six months and remained there for the rest of the study period.

Diabetics who were taking insulin before their weight-loss surgery had 43 percent lower remission rates than patients who didn’t need insulin, the study also found.

Compared to 1,074 similar obese patients with type 2 diabetes who didn’t have RYGB surgery, those who did were less likely to develop so-called microvascular complications like kidney or eye problems

whether or how surgical weight loss might directly improve joint pain or musculoskeletal pain in obese teens.

One limitation of the study is that the data came from a research project designed to study improvements in weight and obesity-related disease, not joint pain, the study authors note.

Another drawback is that data on physical improvements was based on patient surveys, not on objective measures of physical function or body mechanics.

Even so, the results suggest that improved joint health can be added to the

caused by diabetes. With surgery, the risk of eye damage was 48 percent lower and the chance of kidney disease was 46 percent lower.

Within 30 days of surgery, 7.5 percent of patients had repeat hospitalizations for complications related to the gastric bypass procedures.

The study, reported in Diabetologia, wasn’t a controlled experiment designed to prove whether or how weight-loss surgery might help people control diabetes symptoms or reduce the need for diabetes medications.

“Given that it involves major abdominal surgery, having a gastric bypass procedure is certainly not without some major health risks, including short-term complications from the surgery itself and longerterm ones like micronutrient deficiencies due to malabsorption of vitamins and minerals in the diet,” Colberg added.

“This study does suggest that more than half of patients undergoing such surgeries were able to remain diabetes-free, which reduces their risk of the long-term health complications associated with diabetes,” Colberg said.

list of potential health benefits of weight loss surgery, the authors conclude.

“Adolescence represents a window of opportunity for caregivers to implement exercise and behavioral supports pre-and post-surgery to maintain longterm weight and joint health benefits,” the study team writes. “Future research should be focused on studying the relationship among weight loss, biomechanical and systemic inflammatory mechanisms, performance measures, and biomarkers to identify, target, and treat adolescents who are obese and at risk for knee osteoarthritis.”