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Weight loss after sleeve gastrectomy in developmentally delayed adolescents and young adults

Published:August 12, 2019DOI:https://doi.org/10.1016/j.soard.2019.07.029

      Highlights

      • Adolescents with developmental delay have similar weight loss following SG
      • No increase in postoperative adverse events was found

      Abstract

      Background

      Adolescent obesity is a significant factor in caring for patients with developmental delay (DD). Sleeve gastrectomy provides durable weight loss for teens with obesity but requires behavioral change that may not occur in patients with DD.

      Objectives

      To determine whether patients with DD had similar weight loss and adverse outcomes to patients without a diagnosis of DD after sleeve gastrectomy.

      Setting

      Academic children's hospital, United States.

      Methods

      Patients with DD undergoing sleeve gastrectomy were matched to adolescents without DD. Chart review was performed to determine etiology and severity of DD, weight, and body mass index (BMI) change in each group at 3, 6, 9, and 12 months postoperatively. One-year emergency department visits, readmissions, and reoperations were reviewed.

      Results

      Ten patients with DD and 44 patients without DD underwent sleeve gastrectomy between 2008 and 2017. Six patients with DD (60%) had mild cognitive impairment, 3 patients (30%) had moderate cognitive impairment, and 1 patient (10%) had severe cognitive impairment. Patients were 81.5% female, had a mean age of 17.3 years, and had a preoperative BMI of 48.6 kg/m2. Preoperative BMI was similar in the 2 groups, and percent BMI reduction at 1 year was −29% (95% confidence interval: −35 to −23) and −26% (95% confidence interval: −29 to −23) in groups with and without DD respectively (group by time interaction, P = .27).

      Conclusion

      Adolescents with DD experience similar 1-year weight loss and adverse events following sleeve gastrectomy to adolescents without DD. Understanding the long-term outcomes for this population is crucial to ensure appropriate implementation of surgical weight loss programs.

      Key words

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      References

        • Wang C.Y.
        • Gortmaker S.L.
        • Taveras E.M.
        Trends and racial/ethnic disparities in severe obesity among US children and adolescents, 1976-2006.
        Int J Pediatr Obes. 2011; 6: 12-20
        • Kelly A.S.
        • Barlow S.E.
        • Rao G.
        • et al.
        Severe obesity in children and adolescents: identification, associated health risks, and treatment approaches: a scientific statement from the American Heart Association.
        Circulation. 2013; 128: 1689-1712
        • Fitzgerald D.A.
        • Baur L.
        Bariatric surgery for severely obese adolescents.
        Paediatr Respir Rev. 2014; 15: 227-230
        • Colquitt J.L.
        • Pickett K.
        • Loveman E.
        • Frampton G.K.
        Surgery for weight loss in adults.
        Cochrane Database Syst Rev. 2014; 8: CD003641
        • Puzziferri N.
        • Roshek III, T.B.
        • Mayo H.G.
        • Gallagher R.
        • Belle S.H.
        • Livingston E.H.
        Long-term follow-up after bariatric surgery: a systematic review.
        JAMA. 2014; 312: 934-942
        • Inge T.H.
        • Zeller M.
        • Harmon C.
        • et al.
        Teen-Longitudinal Assessment of Bariatric Surgery: methodological features of the first prospective multicenter study of adolescent bariatric surgery.
        J Pediatr Surg. 2007; 42: 1969-1971
        • Inge T.H.
        • Courcoulas A.P.
        • Jenkins T.M.
        • et al.
        Weight loss and health status 3 years after bariatric surgery in adolescents.
        N Engl J Med. 2016; 374: 113-123
        • Inge T.H.
        • Jenkins T.M.
        • Xanthakos S.A.
        • et al.
        Long-term outcomes of bariatric surgery in adolescents with severe obesity (FABS-5+): a prospective follow-up analysis.
        Lancet Diabetes Endocrinol. 2017; 5: 165-173
        • Maiano C.
        • Hue O.
        • Morin A.J.
        • Moullec G.
        Prevalence of overweight and obesity among children and adolescents with intellectual disabilities: a systematic review and meta-analysis.
        Obes Rev. 2016; 17: 599-611
        • Weiss A.L.
        • Mooney A.
        • Gonzalvo J.P.
        Bariatric Surgery: The Future of Obesity Management in Adolescents.
        Adv Pediatr. 2017; 64: 269-283
        • American Psychiatric Association
        Diagnostic and statistical manual of mental disorders.
        5th ed. American Psychiatric Publishing, Arlington2013
        • Pedroso F.E.
        • Angriman F.
        • Endo A.
        • et al.
        Weight loss after bariatric surgery in obese adolescents: a systemic review and meta-analysis.
        Surg Obes Relat Dis. 2018; 14: 413-422
        • Daigle C.R.
        • Schauer P.R.
        • Heinber L.J.
        Bariatric surgery in the cognitively impaired.
        Surg Obes Relat Dis. 2015; 11: 711-714
        • Ryder J.R.
        • Gross A.C.
        • Fox C.K.
        • et al.
        Factors associated with long-term weight-loss maintenance following bariatric surgery in adolescents with severe obesity.
        Int J Obes (Lond). 2018; 42: 102-107
        • Livhits M.
        • Mercado C.
        • Yermilov I.
        • et al.
        Preoperative predictors of weight loss following bariatric surgery: a systemic review.
        Obes Surg. 2012; 22: 70-89