Sleeve Gastrectomy Safe and Effective Long-Term in Kids With Severe Obesity

By Reuters Staff

September 29, 2021

NEW YORK (Reuters Health) - Sleeve gastrectomy is a safe and effective treatment for severe obesity in children as young as five years old, report researchers in Saudi Arabia.

At 10 years, children and adolescents who had sleeve gastrectomy had long-lasting major weight loss and improvement in obesity-related medical problems, with no stunting in their growth in height, the team reports in the Journal of the American College of Surgeons.

"Lack of long-term data and some pediatricians' fears that bariatric surgery might affect children's linear growth has led to worldwide resistance to performing weight loss procedures for children below 14 or 15 years of age," Dr. Aayed R. Alqahtani, professor of bariatric and minimally invasive surgery at King Saud University and chief executive officer of New You Medical Center in Riyadh, said in a statement.

"Our findings present clear evidence that should remove hesitance to perform bariatric surgical treatment in children and young adolescents who could benefit from the operation. We have a proven solution for severe obesity and its comorbidities," said Dr. Alqahtani.

In their paper, the researchers report 10-year outcomes for 2,504 children and adolescents aged 5 to 21 years (mean age, 15.7 years; 45% male) with class-II/III obesity who had sleeve gastrectomy. All of them had failed to lose substantial weight with a six-month weight-loss program involving dietary and behavioral counseling.

The percentage of excess weight loss in the short-term (one to three years), medium-term (four to six years) and long-term (seven to 10 years) was 82.3%, 76.3% and 71.1%, respectively.

Before surgery, 10.5% of patients had diabetes, 9.1% had dyslipidemia and 15.1% had hypertension. At greater than seven years' follow-up, complete remission of these three comorbidities was 71.5%, 57.3% and 58.1%, respectively.

Growth velocity was unaffected by surgery and did not differ between children aged 14 and younger versus older children.

"Owing to the risks associated with childhood obesity, and in light of evidence supporting the role of weight loss surgery in pediatric age groups, surgery and pediatrics scientific societies adopted metabolic and bariatric surgery for children and adolescents with severe obesity. These include the American Academy of Pediatrics and the American Society of Metabolic and Bariatric Surgery," the authors note in their article.

"If you surgically intervene early, you can cure children's obesity-related diseases early and improve their quality of life, and if you wait longer, their diseases might become irreversible," Dr. Alqahtani added in the news release.

The study received funding from the King Abdulaziz City for Science and Technology in Saudi Arabia. The authors report no relevant disclosures.

SOURCE: Journal of the American College of Surgeons, online September 23, 2021.