E. C. Victor1,2, N. V. Mulpuri3, L. S. Burkhalter1, M. Lott2, F. G. Qureshi1,3 1Children’s Medical Center,Division Of Pediatric Surgery,Dallas, Tx, USA 2University Of Texas Southwestern Medical Center,Department Of Psychiatry,Dallas, TX, USA 3University Of Texas Southwestern Medical Center,Department Of Surgery,Dallas, TX, USA
Introduction: Adolescent bariatric surgery is associated with significant weight loss with a reduction in medical comorbidities and improved psychological functioning. To date, there has been limited research exploring individual medical, demographic, and family factors associated with excess weight loss percent (EWL%) postoperatively in adolescents.
Methods: A retrospective chart review of adolescents who underwent sleeve gastrectomy between 2015 and 2018 was performed. A series of forward stepwise linear regressions at 6 weeks, 3 and 6 months postop were conducted to examine medical, family, and demographic factors associated with EWL%. IRB approval was obtained.
Results:47 patients were identified (age 17.6±1.16, body mass index(BMI) 50.71±7.50kg/m2). At 6 weeks, males (M EWL% = 17.68,p=.017) had a greater EWL% than females (M EWL% = 16.52) . Patients with lower BMIs at first surgical appointment (p < .001) also had a greater EWL%. Patients referred from primary care providers and/or a pediatric high-risk obesity clinic (M EWL% = 17.72,p= .003) had a greater EWL% compared to patients referred from a specialty care clinic (M EWL% = 12.30). EWL% at 6 weeks was the greatest predictor of EWL% at 3 months (p<.001) and 6 months (p<.001) post-op. Interestingly, patients with higher BMIs at first surgical appointment, had higher EWL% at 6 months (p<.001). At all post-operative time points, there were no differences in EWL% outcomes with regard to race, ethnicity, age at surgery intake appointment, medical diagnoses (obstructive sleep apnea, hypertension, hyperlipidemia, non-alcoholic fatty liver disease, or type 2 diabetes), mental health diagnosis, insurance type, family history of weight loss surgery, or family members’ successful weight loss maintenance post-op.
Conclusion:For adolescents undergoing bariatric surgery, greatest EWL% at 3 and 6 months post-op was most associated with the amount of weight a patient is able to lose in their first 6 weeks following surgery. Boys also had greater EWL% and BMI at first surgical appointment impacted EWL% differently at 6 weeks and 6 months, perhaps reflecting different rates of weight loss. Additional longitudinal data will be required to validate these findings.
