A Medical Device Daily

Reports have sounded the alarm far and wide about the risks associated with obesity to adults, children and teens. But some encouraging news has been delivered for teenagers, and the physicians who treat them, facing this dilemma.

A new study focusing on morbidly obese teenagers who have had last-resort bariatric surgery found that the procedure poses no greater risks for them than for adults, and in fact, they have a zero death rate and faster recovery.

Researchers at the Robert Wood Johnson Medical School (New Brunswick, New Jersey) and Cincinnati Children's Hospital Medical Center (Cincinnati) used a large national database to examine nationwide trends from 1996 to 2003 in the use of adolescent bariatric surgery, described as the first effort to compare the early post-operative results following bariatric surgery in adolescents and adults.

The study, published in the March issue of Archives of Pediatrics & Adolescent Medicine, shows that surgery among teens has tripled in recent years, increasing in the U.S. from an estimate of just over 200 procedures in 2000 to nearly 800 procedures in 2003.

When researchers compared early post-operative results in teens and adults, they found that teens appear to handle the surgery better than adults. The study found that adolescents, ages 12 to 19, had shorter hospital stays and no in-hospital deaths, whereas a 0.2% mortality rate was recorded for adults.

Morbidly obese adolescents are at risk for Type 2 diabetes, sleep apnea and heart disease but the study found they had significantly fewer co-morbid conditions prior to bariatric surgery compared to adults.

The new study also compared the costs of surgery for adults and teens, finding that adolescents had lower hospital charges. Total hospital charges in 2003 for adolescents undergoing bariatric surgery were $23.6 million and for adults was $3.8 billion. The average hospital charges associated with these procedures were 15% lower for adolescents than for adults. Similar to adults, most adolescents had private insurance.

Although bariatric surgery among adolescents has increased, it is not common, representing fewer than 1% of the bariatric procedures performed nationwide. The study found that although the majority of surgery recipients are female, more male adolescents are requesting it.

At Cincinnati Children's, bariatric surgery is used as a "last resort" for morbidly obese teens who have tried unsuccessfully to lose weight through diet and/or exercise, the center said. More than 70 patients have had bariatric surgery at Cincinnati Children's since the medical center began performing weight loss surgery in 2001.

The center's bariatric research program reports ongoing research studies sponsored by the National Institutes of Health, examining the metabolic, psychological and surgical outcomes of teens undergoing weight loss procedures.