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Outcomes of an adolescent bariatric service
  1. B White1,2,
  2. N Finer2,3,
  3. M Adamo2,
  4. E Duke2,
  5. H Kingett2,
  6. D Christie2,
  7. J Doyle2,
  8. R Batterham2,3,
  9. R Viner1,2
  1. 1General and Adolescent Paediatric Unit, University College London Institute of Child Health, London, UK
  2. 2Obesity and Bariatric Service, University College London Hospital, London, UK
  3. 3Department of Medicine, University College London, London, UK

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/m2 after Roux-en-Y gastric bypass compare favourably to adolescent lifestyle interventions (mean loss = 3.27 kg/m2) and anti-obesity drugs (orlistat mean loss = 0.83 kg/m2, metformin mean loss = 1.43 kg/m2)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/m2 (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/m2 (17.7 kg/m2 with gastric bypass, 13.7 kg/m2 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/m2 (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.

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