Background

Weight loss surgery (WLS) is used to treat severe adolescent obesity and related diseases.Our objective was to assess five-year BMI trajectories following Roux-en-Y Gastric Bypass (RYGB) and Vertical Sleeve Gastrectomy (VSG) in adolescents and evaluate whether early (six-month) BMI change was associated with trajectory group membership.

Methods

Teen-LABS, a prospective observational study at five US centers, enrolled consecutive cases of patients ≤19 yrs having WLS, of which 161 and 67 underwent RYGB and VSG, respectively. Latent class growth modeling was used to construct %BMI change trajectories five years after WLS. The relationship between six-month post-operative %BMI change and trajectory group membership was evaluated using cumulative logit modeling.

Results

Five years after WLS, mean %BMI change for RYGB was -24% (95% CI: -27, -22) and -23% (95% CI: -28, -19) for VSG.Among the RYGB cohort, four unique BMI change trajectories were identified (mean posterior probability of group membership, 0.93).Five-year %BMI change by RYGB trajectory group was: Group 1, -45% (high responders); Group 2, -28%; Group 3, -16%; Group 4, -5% (low responders). For the VSG cohort, three BMI change trajectory groups were identified (mean posterior probability, 0.98). Five-year %BMI change: Group 1, -37% (high responders); Group 2, -21%; Group 3, -7% (low responders). Adjusted cumulative logit modeling indicated that for both RYGB and VSG, greater six-month post-operative %BMI loss was associated with a more successful five-year BMI trajectory.

Conclusions

Five years following WLS, distinct BMI change trajectories were identified among adolescents who underwent RYGB and VSG.Greater six-month postoperative BMI loss was associated with more favorable five-year trajectories.