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

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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.

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Acknowledgments

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

Funding

This research was conducted without funding.

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Authors and Affiliations

  1. Department of Child and Adolescent Psychiatry, Schneider Children’s Medical Center of Israel, Petach-Tikwa, Israel

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

  2. Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    Uriel Fennig & Silvana Fennig

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  1. Uriel Fennig
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  2. Avigal Snir
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  3. Irit Halifa-Kurzman
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  6. Silvana Fennig
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Correspondence to Uriel Fennig.

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The current study received Institutional Review Board approval.

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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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Fennig, U., Snir, A., Halifa-Kurzman, I. et al. Pre-surgical Weight Loss Predicts Post-surgical Weight Loss Trajectories in Adolescents Enrolled in a Bariatric Program. OBES SURG 29, 1154–1163 (2019). https://doi.org/10.1007/s11695-018-03649-8

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