Bariatric surgery in adolescents and young adults--safety and effectiveness in a cohort of 345 patients

Int J Obes (Lond). 2014 Mar;38(3):334-40. doi: 10.1038/ijo.2013.182. Epub 2013 Sep 19.


Objective: To examine the safety and effectiveness of adolescent bariatric surgery and to improve treatment recommendations for this age group.

Design: Prospective longitudinal registry. Since January 2005, patients undergoing bariatric surgery in Germany are enlisted in an online registry called 'study for quality assurance in obesity surgeries'.

Subjects: Adolescents and young adults up to the age of 21 years, operated from January 2005 to December 2010.

Measurements: Weight, BMI, comorbidities, complication rates.

Results: N=345 primary procedures were recorded by 58 hospitals. N=51 patients were under the age of 18 years. Follow-up information was available for 48% (n=167) of patients, with an average observation period of 544±412 days (median: 388 days). The most common surgical techniques were gastric banding (n=118, 34.2%), gastric bypass (n=116, 33.6%) and sleeve gastrectomy (n=78, 22.6%). Short-term complications (intra-operative; general postoperative; specific postoperative) were slightly lower for gastric banding (0.8%; 2.5%; 0.8%) than for gastric bypass (2.6%; 5.2%; 1.7%) or sleeve gastrectomy (0%; 9.0%; 7.7%). In accordance with published findings, weight and BMI reduction were lower for gastric banding (-28 kg; -9.5 kg m(-2)) compared to gastric bypass (-50 kg; -16.4 kg m(-2)) P< 0.001 or sleeve gastrectomy (-46 kg; -15.4 kg m(-2)) P< 0.001. Outcomes did not differ between the <18 and ≥18-year-old patients.

Conclusion: Like in adults, bariatric surgery has low short-term complication rates and results in sustained weight loss in adolescents. However, the missing long-term observations prohibit a final conclusion about lasting effectiveness and safety. Clinical trials with structured follow-up programs and mechanisms to ascertain patient adherences are needed.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Comorbidity
  • Female
  • Follow-Up Studies
  • Gastrectomy* / adverse effects
  • Gastric Bypass* / adverse effects
  • Germany / epidemiology
  • Humans
  • Male
  • Obesity, Morbid / blood
  • Obesity, Morbid / epidemiology
  • Obesity, Morbid / surgery*
  • Outcome Assessment, Health Care
  • Patient Selection
  • Prospective Studies
  • Registries
  • Remission Induction / methods
  • Risk Assessment
  • Severity of Illness Index
  • Treatment Outcome
  • Weight Loss*
  • Young Adult