Pre-surgical Weight Loss Predicts Post-surgical Weight Loss Trajectories in Adolescents Enrolled in a Bariatric Program

Uriel Fennig, Avigal Snir, Irit Halifa-Kurzman, Adi Sela, Arie Hadas, Silvana Fennig

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Introduction: Adolescent obesity is markedly increasing worldwide and bariatric surgery is emerging as an effective treatment option. However, a subset of patients fails to achieve significant weight loss or show post-surgical weight regain. Efforts have been made to identify different post-surgical weight trajectories and their possible predictors. Furthermore, the role of pre-surgical intervention programs in optimizing post-surgical results has been a subject of debate. Objectives: This study aimed to evaluate the impact of a 3-month lifestyle-oriented pre-surgical program for adolescent candidates for bariatric surgery on pre-surgical weight loss (body mass index (BMI) on completion − BMI at admission), and to identify predictors of different post-surgical weight loss trajectories. Methods: Forty-eight adolescent bariatric surgery candidates were enrolled in a lifestyle- and behavior-oriented bariatric program consisting of a 3-month pre-surgical outpatient intervention and a 6-month post-surgical follow-up. Results: Mean BMI decreased by 1.82 points (SD = 1.83) during the program’s pre-surgical intervention phase, a 3.8% average drop in participants’ BMI; post-surgical weight loss trajectories were significantly associated in a curvilinear model with pre-surgical weight loss; optimal post-surgical results were associated with moderate pre-surgical weight loss, and inversely associated with maternal history of obesity, early-life weight loss attempts, and comorbid learning disorders. Conclusions: Moderate weight loss in a pre-surgical lifestyle-oriented intervention program predicts optimal post-surgical weight loss. Additionally, by assessing risk factors and pre-surgical weight loss patterns, it may be possible to identify sub-populations of adolescents undergoing bariatric surgery at risk of achieving sub-optimal long-term results.

Original languageEnglish
Pages (from-to)1154-1163
Number of pages10
JournalObesity Surgery
Volume29
Issue number4
DOIs
StatePublished - 15 Apr 2019
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2019, Springer Science+Business Media, LLC, part of Springer Nature.

Keywords

  • Adolescents
  • BMI
  • Bariatric surgery
  • Intervention
  • Laparoscopic sleeve gastrectomy (LSG)
  • Lifestyle
  • Obese
  • Pre-surgical
  • Prediction
  • Program
  • Trajectory

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