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Adolescent health
Outcomes of 50 patients entering an adolescent bariatric surgery programme
  1. Billy White1,2,
  2. Jacqueline Doyle3,
  3. Kirsten Matschull2,
  4. Marco Adamo4,
  5. Deborah Christie3,
  6. Dasha Nicholls5,
  7. Sanjay Kinra6,
  8. Ian Chi Kei Wong7,
  9. Russell M Viner1,2
  1. 1 Department of Population Health Sciences, UCL Institute of Child Health, London, UK
  2. 2 Department of Adolescent Medicine, University College London Hospitals NHS Foundation Trust, London, UK
  3. 3 Department of Child and Adolescent Psychological Services, University College London Hospital, London, UK
  4. 4 Department of Surgery, University College London Hospital, London, UK
  5. 5 Feeding and Eating Disorders Service, Great Ormond Street Hospital, London, UK
  6. 6 Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
  7. 7 Centre for Paediatric Pharmacy Research, University College London School of Pharmacy, London, UK
  1. Correspondence to Dr Billy White, Department of Adolescent Medicine, University College London Hospitals NHS Foundation Trust, London, UK; billy.white{at}ucl.ac.uk

Abstract

Objective Bariatric surgery is the most effective intervention for weight loss and obesity-related comorbidities currently available. Little is known about adolescents entering National Health Service (NHS) bariatric programmes. We aimed to characterise those entering a pathway and report their outcomes.

Design Prospective service evaluation of patients assessed within a single NHS adolescent bariatric service.

Results 50 patients assessed between 26 July 2007 and 27 January 2014; 6 (12%) were not eligible for surgery, 7 (14%) actively opted out, 8 (16%) were lost to follow-up and 29 (58%) underwent surgery (18 sleeve gastrectomy (SG) 11 Roux-en-y gastric bypass (RYGB) and 0 adjustable gastric band). Mean (SD) age at initial assessment was 16.0 (1.3) years and 18.3 (1.3) at surgery (youngest 15.7 years). Mean time taken to surgery was 1.8 years; longer in those with higher body mass index (BMI) and aged below 14 at first assessment. Mean (SD) BMI at surgery was 53.1 (8.3) kg/m2, lower in those undergoing RYGB (−5.2, 95% CI −11.6 to 1.13). Follow-up was inconsistent and challenging; 1/29 (3.5%) was transferred to a regional centre, 10/29 (34.5%) attended ongoing follow-up within our protocol, 6/29 (20.7%) had intermittent monitoring and 12/29 (41.4%) were lost to follow-up. Mean BMI change at 1 year (−14.0 kg/m2) and complications were similar to published cohorts. Data from 11 lost to follow-up were obtained and outcomes appeared similar to those who actively followed up.

Conclusion Adolescent bariatric surgery in the NHS appears effective, with outcomes similar to those reported internationally. Further work is needed to optimise postsurgical surveillance and reduce age at surgery.

  • bariatric surgery
  • obesity
  • adolescent
  • child

https://doi.org/10.1136/archdischild-2017-312670

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    Footnotes

    • Contributors BW collected and analysed the data, drafted and revised the paper. He is guarantor. KM was involved in data collection. JD, DC, DN, MA, SK and ICKW were all involved in the conception of the study and revised the draft paper. RMV initiated the concept, supervised data analysis and drafted and revised the paper. All authors approved the final version of the paper.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Further data are available from the authors.