Background

Nonadherence to follow-up after bariatric surgery is associated with lower long-term weight loss. Yet, limited data exists on the youngest bariatric population, adolescents and young adults (AYA), who experience life changes that can interrupt follow-up. This study compared follow-up adherence between AYA and assessed the impact of follow-up interruption on weight loss.

Methods

Using an institutional registry, we retrospectively reviewed adolescents (age 14-19) and young adults (YA)(age >19-31) who underwent bariatric surgery between January 2018 and May 2023. Primary outcome was follow-up compliance (1,3,6,12,18,24 months). Operations occurring <2 years ago were excluded from respective time points.

Results

Of 79 (23.9%) adolescents and 251 (76.1%) YA, median preoperative BMI was higher in adolescents (51.0 [45,57] vs. 48.6 [43,54], p=0.003). Median total body weight loss percentage (%TBWL) was greater in YA up to 6 months postoperatively (24% [21,27] vs. 21% [15,26.5], p=0.025) but did not differ afterward. Median missed follow-up appointments were similar between adolescents (3 [2,4]) and YA (3 [1,4]). Adolescents were more likely to be lost to follow-up at 6 months (41.1% vs 16.7%, p=0.001). At 12 months, 73.3% of adolescents and 62.8% of YA were lost to follow-up (p=ns), which grew to 92.3% and 85.9% at 2 years (p=ns).

Conclusions

Clinic adherence in the post-bariatric AYA population is poor. While weight loss was similar in AYA, long-term weight loss data is limited to those who follow-up. Identifying when AYA are at risk of lost to follow-up allows for targeted interventions to maximize adherence and improve long-term health.