Outcomes of an adolescent bariatric service. (24th May 2012) - White, B
Abstract : Aims: Bariatric surgery has been shown to be the most effective available intervention for weight loss1 . The literature is largely confined to adults but outcome data for adolescents undergoing surgery appear consistent with adult data2 . Mean weight loss of approximately 20 kg/m 2 after Roux-en-Y gastric bypass compare favourably to adolescent lifestyle interventions (mean loss = 3.27 kg/m 2 ) and anti-obesity drugs (orlistat mean loss = 0.83 kg/m 2, metformin mean loss = 1.43 kg/m 2 )3, 4, 5 . Results: 38 young people (YP) have been through the adolescent bariatric pathway at a tertiary hospital since 2007, 11 of whom have completed bariatric surgery. 13 YP aged 14.1 to 18.5 years (mean 16.5 years) are currently undergoing assessment and preparation for surgery. 5 YP have completed surgery within the adolescent bariatric surgery programme. All had completed puberty and were aged 15.5 to 18.6 years. Mean pre-operative BMI was 54.5 kg/m 2 (range 47.9-77.4). 2/5 had Roux-en-Y gastric bypass procedure, 3/5 had sleeve gastrectomy and 0/5 had gastric band. Mean BMI loss was 15.3 kg/m 2 (17.7 kg/m 2 with gastric bypass, 13.7 kg/m 2 sleeve gastrectomy) and a mean follow-up time of 1.0 year. 9 YP have been assessed and discharged: 3 were not eligible, and 6 decided that they did not want surgery at the time. 12 patients transitioned to the adult bariatric service at the same institution and 5 underwent surgery (age range 17.9 to 19.5 years): 2/5 had Roux-en-Y gastric bypass, 3/5 had gastric sleeve and 0/5 had gastric band. Mean BMI change was −6.1 kg/m 2 (range +0.2 to −9.9) with a mean follow-up of 0.7 years. One further patient had surgery within the private sector and no follow up data is available. Conclusion: 11 young people (30% of those who entered the pathway) have undergone bariatric surgery with outcomes comparable to adult studies. Bariatric surgery appears effective and relatively safe within an NHS pathway.