Obese Teens Gain Mobility After Bariatric Surgery, Study Finds

Teenagers who started with an average BMI of 51.7 were able to reduce that by more than 40% over the first year after surgery. They were able to complete a lap of an outdoor track nearly a half-minute faster on average, and fewer reported being in pain.

Severely obese teenagers could walk faster and had less pain and lower heart rates after having bariatric surgery, a new study in JAMA Pediatrics has found.1

The results come as bariatric surgery is gaining acceptance from leading medical societies as a way to not only help patients lose weight, but also reverse diabetes. However, strong evidence for the appropriateness of surgery for teenagers is lacking, as noted in a recent statement from leading diabetes groups in the June issue of Diabetes Care.2 There are concerns that growing adolescents may not receive key nutrients due to surgery.

However, severely obese teenagers already experience the side effects of obesity, according to the study published Monday. Researchers followed 242 severely obese teenagers who had surgery—their average body mass index (BMI) was 51.7 kg/m2. CDC defines obesity as having a BMI of 30 kg/m2 or higher. The teenagers had surgery between 2007 and 2012 at 5 adolescent bariatric surgery center in the United States.

After surgery, the teenagers had made significant progress in losing weight and in alleviating complications of severe obesity. At 6 months, the average BMI decrease was 32.5%, and by 12 months, BMI had dropped an additional 7.8%. An additional decrease of 0.2% was seen at 24 months.

Of the group, 206 participants completed a 400 meter walk test prior to surgery, and at 6 months (195 participants), 12 months (176 participants) and 24 months (149 participants). A 400-meter walk is one lap around a standard outdoor track, or about one-quarter mile.

At 6 months, the time to complete the walk dropped 29 seconds, from 6.3 minutes to 5.8 minutes. Resting heart rate improved from 84 beats per minute (bpm) to 74 bpm. Heart rates after the test dropped from 128 bpm to 113 bpm, and the difference went from 40 bpm to 34 bpm.

Researchers also measured how much musculoskeletal pain participants reported. Before surgery, nearly one-quarter of the participants reported being in pain after the 400 meter test, but that share dropped below 10% at the 6-month mark. Pain levels remained well below pre-surgery levels through 24 months.

“The reduction in pain following bariatric surgery could translate to increased activity patterns in adolescents with severe obesity, because joint pain can influence willingness to engage in activity,” the researchers wrote.

The authors note they lacked a control group who did not have surgery, and that they will not know long-term benefits for years. “Whether these positive changes in functional mobility and musculoskeletal pain persist over the long-term and lead to further improvements in cardiometabolic risk requires evaluation,” they write.

References

1. Ryder JR, Edwards NM, Gupta R, et al. Changes in functional mobility and musculoskeletal pain after bariatric surgery in teens with severe obesity [published online July 18, 2016]. JAMA Pediatr. 2016; doi: 10.1001/jamapediatrics.2016.1196.

2. Rubino F, Nathan DM, Eckel RH, et al. Metabolic surgery in the treatment algorithm for type 2 diabetes: a joint statement by international diabetes organizations. Diabetes Care. 2016;39(6):861-877. http://dx.doi.org/10.2337/dc16-0236