Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Aug;33(8):2475-2484.
doi: 10.1007/s11695-023-06673-5. Epub 2023 Jun 26.

A Population-Based Cohort Study on Efficacy and Safety of Bariatric Surgery in Young Adults Versus Adults

Kelly G H van de Pas  1   2   3 , Aliyar Esfandiyari Noushi  4 , Loes Janssen  4 , Anita C E Vreugdenhil  5   6 , Wouter K G Leclercq  4 , François M H van Dielen  4 ; Dutch Audit for Treatment of Obesity Research Group
Collaborators, Affiliations

A Population-Based Cohort Study on Efficacy and Safety of Bariatric Surgery in Young Adults Versus Adults

Kelly G H van de Pas et al. Obes Surg. 2023 Aug.

Abstract

Purpose: Bariatric surgery is the most effective treatment for severe obesity in adults and has shown promising results in young adults. Lack of insight regarding efficacy and safety outcomes might result in delayed bariatric surgery utilization in young adults. Therefore, this study aimed to assess the efficacy and safety of bariatric surgery in young adults compared to adults.

Methods: This is a nationwide population-based cohort study utilizing data from the Dutch Audit Treatment of Obesity (DATO). Young adults (aged 18-25 years) and adults (aged 35-55 years) who underwent primary Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) were included. Primary outcome was percentage total weight loss (%TWL) until five years postoperatively.

Results: A total of 2,822 (10.3%) young adults and 24,497 (89.7%) adults were included. The follow-up rates of the young adults were lower up to five years postoperatively (46.2% versus 56.7% three years postoperatively; p < 0.001). Young adults who underwent RYGB showed superior %TWL compared to adults until four years postoperatively (33.0 ± 9.4 versus 31.2 ± 8.7 three years after surgery; p < 0.001). Young adults who underwent SG showed superior %TWL until five years postoperatively (29.9 ± 10.9 versus 26.2 ± 9.7 three years after surgery; p < 0.001). Postoperative complications ≤ 30 days were more prevalent among adults, 5.3% versus 3.5% (p < 0.001). No differences were found in the long term complications. Young adults revealed more improvement of hypertension (93.6% versus 78.9%), dyslipidemia (84.7% versus 69.2%) and musculoskeletal pain (84.6% versus 72.3%).

Conclusion: Bariatric surgery appears to be at least as safe and effective in young adults as in adults. Based on these findings the reluctance towards bariatric surgery in the younger age group seems unfounded.

Keywords: Adults; Bariatric surgery; Gastric bypass; Gastric sleeve; Young adults.

PubMed Disclaimer

Conflict of interest statement

K.G.H. van de Pas, A. Esfandiyari Noushi, L. Janssen, A.C.E. Vreugdenhil, W.K.G. Leclercq, and F.M.H. van Dielen declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Flow diagram of the inclusion and exclusion of participants
Fig. 2
Fig. 2
Percentage TWL between young adults and adults until five years after surgery, stratified for bariatric procedure (RYGB = panel A, SG = panel B) and determined by a linear mixed model (including age category, time and their interaction)
See this image and copyright information in PMC

References

    1. English WJ, Williams DB. Metabolic and Bariatric Surgery: An Effective Treatment Option for Obesity and Cardiovascular Disease. Prog Cardiovasc Dis. 2018;61(2):253–269. doi: 10.1016/j.pcad.2018.06.003. - DOI - PubMed
    1. van de Pas KGH, Bonouvrie DS, Janssen L, et al. Roux-en-Y Gastric Bypass Versus Sleeve Gastrectomy in Young Adults: a Dutch Registry Study. Obes Surg. 2022;32(3):763–770. doi: 10.1007/s11695-021-05846-4. - DOI - PubMed
    1. Zeitler P, Hirst K, Pyle L, et al. A clinical trial to maintain glycemic control in youth with type 2 diabetes. N Engl J Med. 2012;366(24):2247–2256. doi: 10.1056/NEJMoa1109333. - DOI - PMC - PubMed
    1. Kahn SE, Haffner SM, Heise MA, et al. Glycemic durability of rosiglitazone, metformin, or glyburide monotherapy. N Engl J Med. 2006;355(23):2427–2443. doi: 10.1056/NEJMoa066224. - DOI - PubMed
    1. Jebeile H, Cardel MI, Kyle TK, et al. Addressing psychosocial health in the treatment and care of adolescents with obesity. Obes (Silver Spring) 2021;29(9):1413–1422. doi: 10.1002/oby.23194. - DOI - PubMed

LinkOut - more resources