Background

This study seeks to answer the question of whether patients derive long term benefit from receiving surgical management of obesity early in life.

Methods

134 patients aged 18-21 at time of surgery, who underwent sleeve gastrectomy or gastric bypass between 2009-2022 were included. The primary outcome was weight loss at 1-, 3-, 5- and 10-year time points. The secondary outcomes were glycemic control in all patients and resolution of PCOS in female patients after surgery.

Results

The majority of patients in this cohort were female (91.8%). The average preoperative BMI was 42.2. At one year post-op, 74.6% of patients had lost >50% of their excess body weight (n=134). However this decreased to 59.7% by 3 years, 46.0% by 5 years and 38.1% at 10 years. Similarly, whereas 47.8% of patients had remission of obesity at 1 year, only 37.0% were in remission at 3 years, 23.0% at 5 years and 21.4% at 10 years. Promisingly, none of the patients with prediabetes (A1c > 5.7%) progressed to diabetes and all had subsequent improvement in glycemic control. Out of the female patients, 27.6% had a diagnosis of polycystic ovarian syndrome at the time of surgery. 2/34 had documented resolution post-surgery and 14/34 went on to have children later on in life.

Conclusions

Metabolic surgery has the potential to ameliorate obesity and related comorbidities for a proportion of patients undergoing surgery at a young age though life-long support is likely needed to help attain the full benefit of surgery.