Obesity Surgery

, Volume 29, Issue 4, pp 1154–1163 | Cite as

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

  • Uriel FennigEmail author
  • Avigal Snir
  • Irit Halifa-Kurzman
  • Adi Sela
  • Arie Hadas
  • Silvana Fennig
Original Contributions



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.


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.


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.


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.


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.


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



We acknowledge all team members working at the bariatric clinic at Schneider Children’s Medical Center of Israel.

Funding Information

This research was conducted without funding.

Compliance with Ethical Standards

The current study received Institutional Review Board approval.

Conflict of Interest

The authors declare that they have no conflict of interest.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Statement of Human and Animal Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Child and Adolescent PsychiatrySchneider Children’s Medical Center of IsraelPetach-TikwaIsrael
  2. 2.Sackler School of MedicineTel-Aviv UniversityTel-AvivIsrael

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