Background

Pediatric obesity currently affects 20% of children and adolescents in the United States. The American Academy of Pediatrics recommends bariatric surgery to treat adolescents with severe obesity. Resting Energy Expenditure (REE) is the metabolic rate required to maintain an individual's vital physiological functions and can be measured by indirect calorimetry. REE has been shown to decrease with conventional weight loss methods and increase with Roux en Y gastric bypass. Changes in REE following sleeve gastrectomy remain unclear. In this study, we describe REE profiles in pediatric patients with severe obesity before and after sleeve gastrectomy.

Methods

After obtaining IRB approval, patients seen at Stanford Children's Adolescent Bariatric Surgery Clinic were approached to enroll in our study from October 2021- May 2023. Data was collected through health records and stored in REDCap. REE measurements were obtained using indirect calorimetry and body composition was measured with Dual Energy X-ray Absorptiometry (DXA) scans. Primary analysis was conducted using student t test and correlation analysis using R software.

Results

29 participants underwent indirect calorimetry and DXA scan prior to sleeve gastrectomy. Lean% body mass was positively correlated with pre-intervention REE cal/kg. There was no significant difference in REE cal/kg before and after patients underwent sleeve gastrectomy. Pre -intervention REE cal/kg did not show a significant correlation with change in BMI after sleeve gastrectomy.

Conclusions

This is the first study examining REE profiles in adolescents undergoing sleeve gastrectomy. Larger longitudinal studies would help investigate the relationship between REE and weight changes following sleeve gastrectomy.