Background

Metabolic and bariatric surgery (MBS) is the most effective treatment for adolescent severe obesity, but is rarely considered for youth with intellectual disability (ID). Current MBS guidelines lack specificity for evaluating youth with ID and research is limited in characterizing this population. Objective: To determine the level of functioning, health, and psychosocial characteristics of adolescents/young adults with ID presenting for MBS. Setting: A single multidisciplinary adolescent MBS center

Methods

A prospective observational design was used as part of a larger, longitudinal study. Patients age 10-25 with diagnosed or suspected ID were screened. Participants/parents completed validated measures of intellectual (IQ) and adaptive functioning, parenting stress, and quality of life (QOL).

Results

Of 76 patients presenting for surgery since June 2017, 11% (n=8) were consented. Participants were all female with mean age of 17 (13-22), 75% had class 3 severe obesity, and 63% had either type 2 diabetes or prediabetes. ID etiology included autism, nonaccidental trauma, and craniopharyngioma. Mean IQ was 77 (“average intelligence”=100), and ranged from 64-91. Mean adaptive function, reflecting practical life skills, was 83 (“average”=100) and ranged from 67-111. Mean parenting stress was considered normal at the 57th%ile (range 3rd-99th%ile). Mean parent-reported QOL for their child was 60 on a scale of 0-100 (range 28-98).

Conclusions

Adolescents/young adults with ID presenting for MBS show significant variability in etiology and severity of ID and in personal and family functioning domains. Such variability presents opportunities to tailor pre and post-operative care to optimize the safety and efficacy of MBS.