Weight Nadir and Long-Term Weight Outcomes After Laparoscopic Sleeve Gastrectomy in a Diverse Cohort of Adolescents and Young Adults

• Published in: Obesity surgery Vol. 34; no. 8; pp. 2965 - 2973
• Main Authors: Hornick, Matthew A., Chao, Grace. F., Ying, Lee D., Nadzam, Geoffrey, Duffy, Andrew, Ghiassi, Saber, Graetz, Elena, Gibbs, Karen E., Morton, John M.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-08-2024; Springer Nature B.V
• Subjects: Adolescent; Adult; Bariatric Surgery - methods; Bariatric Surgery - statistics & numerical data; Female; Gastrectomy - methods; Gastrointestinal surgery; Humans; Laparoscopy; Male; Medicine; Medicine & Public Health; Obesity, Morbid - surgery; Original Contributions; Retrospective Studies; Surgery; Teenagers; Treatment Outcome; United States - epidemiology; Weight Loss; Young Adult; Young adults; United States; United States > US; Weight nadir; Sleeve gastrectomy; Long-term weight loss
• ISSN: 0960-8923; 1708-0428; 1708-0428
• DOI: 10.1007/s11695-024-07374-3

Introduction
Laparoscopic sleeve gastrectomy (LSG) is currently the most common bariatric procedure performed in adolescents and young adults in the United States (USA), but there are limited data available on long-term postoperative weight outcomes in these patients. This single-institution US study follows longitudinal weight data in a diverse group of patients undergoing LSG at age 25 years or younger.
Methods
We retrospectively reviewed records of all patients 25 years or younger who underwent LSG at our institution between 2013 and 2020. All weight data documented in the medical record through January 2023 was included. We calculated weight change postoperatively as percent total weight loss (%TWL) relative to preoperative weight.
Results
One hundred forty-one patients underwent LSG, at a mean age of 23.1 years. Within this cohort, 56.1% identified as non-Hispanic Black or Hispanic, and 39.7% had private health insurance. The mean %TWL at weight nadir was 28.5% at a mean of 1.35 years postoperatively. The mean long-term %TWL (in patients with ≥ 4 years of follow-up) was 11.8% at a mean of 5.6 years postoperatively, with 43 of the 84 patients with long-term weight data (51%) within 10% of their preoperative weight at most recent follow-up.
Conclusion
Adolescents and young adults undergoing LSG at our institution had weight nadir comparable to published results during the first 1 to 2 years postoperatively, but the majority developed significant weight recurrence over the ensuing years. Our findings highlight the need for adjuvant weight loss strategies to improve the durability of weight outcomes after LSG in this population.
Graphical Abstract