Abstract
Background
Roux-en-Y gastric bypass (RYGB) in adolescence results in substantial bodyweight reduction
and cardiometabolic benefits into young adulthood. Knowledge gaps remain in understanding
psychosocial health.
Objective
Describe trajectories of weight and psychosocial health in adolescents who underwent
RYGB into young adulthood.
Setting
Academic Pediatric Medical Center.
Methods
Fourteen adolescents (presurgery: mean body mass index = 59.2±8.9; mean age = 16.0±1.3
yr; 64.3% female) participated in 2 sequential observational studies. Height and weight
were measured, and participants completed measures of weight-related quality of life
(WRQOL), mental health, and adaptive functioning at presurgery and 6, 12, 18, 24,
and 72+months postsurgery. Substance use behaviors were assessed at 72+months.
Results
Modeling demonstrated rapid improvement in body mass index and WROQL across postoperative
year 1, followed by stabilization and modest weight regain/WRQOL decline (P<.001), with 50% remaining severely obese. Presurgery, 11 adolescents presented with
symptoms outside of the normal range for≥1 mental health domain. Postoperative profiles
indicated either remittance (n = 5) or persistent symptomatology (n = 6: anxious/depressed,
withdrawn/depressed, and/or thought problems) in young adulthood. No new incidence
of mental health vulnerability occurred in young adults not already identified preoperatively.
Adaptive functioning and substance use were within normal range.
Conclusions
Although adolescent RYGB resulted in improvement in weight and WRQOL into young adulthood,
mental health trajectories were more variable, with some experiencing positive change
while others experienced persistent mental health vulnerability. Research focused
on larger contemporary samples using a controlled design is critical to inform targets
for prevention and intervention to optimize both physical and psychosocial health
outcomes in this younger patient population.
Keywords
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Article info
Publication history
Published online: March 21, 2017
Accepted:
March 13,
2017
Received:
January 4,
2017
Footnotes
☆Supported by: Study 1 was supported by a CReFF award (PI: Zeller) Cincinnati Children’s Hospital Medical Center-General Clinical Research Center (USPHS grant M01 RR 08084 from the General Clinical Research Centers Program, National Center for Research Resources/National Institutes of Health), and the National Institutes of Health (R03 DK0788901; PI: Zeller). FABS5+was supported by investigator initiated grants from Ethicon Endo-Surgery (grants 15161 and 15151.3) (PI: Inge). Dr. Hunsaker’s effort was supported by an NIH postdoctoral training grant (T32 DK063929).
Identification
Copyright
© 2017 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
