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. 2019 Apr;29(4):1154-1163.
doi: 10.1007/s11695-018-03649-8.

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

Uriel Fennig  1   2 , Avigal Snir  3 , Irit Halifa-Kurzman  3 , Adi Sela  3 , Arie Hadas  3 , Silvana Fennig  3   4
Affiliations

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

Uriel Fennig et al. Obes Surg. 2019 Apr.

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.

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

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