Personal history of obesity matters. Adolescent adiposity may influence the late results of gastric bypass performed in adults

Endokrynol Pol. 2013;64(1):2-6.

Abstract

Introduction: The influence of adolescent obesity on weight loss following bariatric surgery in adults has not been evaluated. The purpose of this study was to determine the impact of prior adolescent obesity on long-term weight changes following Roux-en-Y gastric bypass (RYGB) in adulthood.

Material and methods: This single centre retrospective cohort study evaluated changes in body mass index (BMI) after RYGB within 9-13 years. Questionnaires were sent by post to patients (n = 147) operated on between January 1999 and December 2003 in the Department of General and Transplant Surgery of Medical University, Lodz, Poland. Long-term data was obtained from 33.33% (n = 49, mean age 46.1 ± 10.7 years). Preoperative, nadir and actual BMI and differences between these values were calculated. Data was analysed with a cut-off BMI at 18 years old of 30 and 35 units (U).

Results: Patients with a BMI of more than 30 and 35 U in adulthood regained more weight after initial achievement of nadir total weight loss compared to their only adult obese counterparts. Preoperative BMI varied by weight at 18 years old (p = 0.02), while value and time to nadir postoperative BMI and actual BMI were comparable.

Conclusion: Adolescent obesity may be a risk factor for long-term RYGB failure. Surgery cannot be definitively curative in this group of patients, and continued active conservative treatment is required.

MeSH terms

  • Adolescent
  • Adult
  • Analysis of Variance
  • Body Mass Index
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Gastric Bypass*
  • Humans
  • Male
  • Medical History Taking
  • Middle Aged
  • Obesity / surgery*
  • Recurrence
  • Retrospective Studies
  • Treatment Outcome
  • Weight Loss
  • Young Adult