Significant Research Reveals Enduring Advantages for Adolescents a Decade Post-Weight Loss Surgical Interventions
New research published recently reveals that teenagers who undergo surgery to manage their extreme obesity continue to see benefits a full decade afterward. These individuals generally maintain a substantial weight loss, and many have managed to avoid obesity-related diseases like type 2 diabetes and high blood pressure.
Despite the emergence of newer GLP-1 medications, such as semaglutide (Ozempic and Wegovy), bariatric surgery remains the most potent treatment for obesity. Patients can shed up to 30% of their initial body weight through these surgeries. Furthermore, studies have indicated that bariatric procedures can improve a person's overall health, including curbing type 2 diabetes and reducing the risk of premature death. However, prior research has primarily centered on adults, making this recent analysis even more significant.
The study, referred to as Teen-LABS (Longitudinal Assessment of Bariatric Surgery), commenced in 2003 and is funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The initial stages of the project involved tracking the health of thousands of teenagers who had undergone bariatric surgery for extreme obesity between 2005 and 2009. In the latest follow-up, published in the New England Journal of Medicine on Wednesday, researchers examined the weight and health results of 260 patients during the decade following their surgery - a milestone that had never been achieved before.
Justin Ryder, the study's lead author and Vice Chair of Research in the Department of Surgery at Ann & Robert H. Lurie Children's Hospital of Chicago, mentioned that the Teen-LABS study offers the "longest adolescent bariatric surgery follow-up," outperforming earlier studies, which at best had follow-up periods of 5 years.
The findings indicate an average 20% sustained weight loss across all patients. Approximately 55% of those diagnosed with type 2 diabetes at the onset maintained their diabetes remission. Likewise, researchers documented a 54% reduction in cases of high blood pressure and high cholesterol.
Bariatric surgery has been shown to deliver long-term benefits for adult patients as well. When compared to the results from this research, it appears that younger patients are more prone to experience these benefits in the long run (remission rates in adults are lower, for instance). According to Ryder, this suggests that addressing obesity with surgery early in a person's life could yield better results.
However, as with any medical treatment, bariatric surgery comes with its share of risks and side effects. There are various types of bariatric surgery, and they work by altering a person's digestive system, including removing parts of the stomach. Consequently, individuals' lifestyles, particularly their eating habits, must significantly change post-surgery. To ensure adequate nutrient intake, individuals may require additional supplements, since certain nutrients may now be difficult to absorb. Moreover, they may become more susceptible to alcohol abuse, as their stomachs have reduced capacity for alcohol metabolism. Lastly, in the short term, patients may have an elevated risk of suicide and self-harm. Approximately 10% of patients may struggle to lose or regain their weight.
Two decades have passed since the original Teen-LABS study started. Over this time, bariatric surgeries have become safer and less invasive. Furthermore, it is plausible that the advantages of surgery may be even more potent today for those with severe obesity or associated conditions, such as type 2 diabetes.
An intriguing aspect to consider is whether these long-term benefits can be generalized to other treatments. Emerging GLP-1 medications, such as semaglutide and tirzepatide, have shown excellent average weight loss success, with newer drugs potential to rival or surpass that achieved through surgery. Ryder cautions, however, that direct comparisons between these treatments are challenging at this stage, given the absence of studies investigating the two side by side.
Ryder concludes that both medications and surgery have their roles in addressing obesity. Multiple treatments may ultimately benefit patients who opt for surgery, and further research is needed to determine the optimal approach. He also emphasizes that teenagers confronting obesity should have better access to effective treatments, a change he suggests that other obesity experts have been advocating for in recent times.
The potential role of technology and science in future obesity treatments is an intriguing thought, especially with the development of GLP-1 medications like semaglutide and tirzepatide. These drugs have shown significant weight loss success, potentially rivaling or surpassing that achieved through surgery.
Furthermore, as advancements in technology continue to make bariatric surgeries safer and less invasive, the 'future of health' could see a fusion of medical treatments, where both medications and surgery work synergistically to provide the best possible outcomes for obese patients, particularly those with severe conditions like type 2 diabetes.
