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. 2025 Jun;33(6):1126-1135.
doi: 10.1002/oby.24285. Epub 2025 Apr 21.

Functional mobility and pain are improved for 6 years after adolescent bariatric surgery

Neil Thivalapill  1 , Todd M Jenkins  2   3 , Thomas H Inge  4   5 , Changchun Xie  2 , Anita P Courcoulas  6 , Carroll M Harmon  7 , Michael A Helmrath  3 , Stephanie Sisley  8 , Marc P Michalsky  9 , Justin R Ryder  4   5 ; Teen‐Longitudinal Assessment of Bariatric Surgery (Teen‐LABS) consortium
Affiliations

Functional mobility and pain are improved for 6 years after adolescent bariatric surgery

Neil Thivalapill et al. Obesity (Silver Spring). 2025 Jun.

Abstract

Objective: The long-term durability of improvements in functional mobility and musculoskeletal pain for adolescents after metabolic and bariatric surgery (MBS) is unknown.

Methods: We used the Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) study to determine the change in mobility and pain among adolescents who underwent MBS. From standardized 400-m walk tests, we analyzed walk time, heart rate (HR) parameters, and musculoskeletal pain.

Results: The mean walk time improved from 383 s (95% CI: 368-399) prior to surgery to 351 s (95% CI: 330-372) by 6 years. The mean resting HR was 90 beats per minute (bpm; 95% CI: 87-93) preoperatively and decreased to 80 bpm (95% CI: 76-84) by 6 years. The risk of any musculoskeletal pain decreased from 37.2% (95% CI: 25.5%-48.9%) to 11.0% (95% CI: 4.3%-17.6%) by 6 years. Mediation analysis revealed that the effect of time since surgery on walk time, resting HR, and HR recovery occurred through a weight-dependent mechanism. For posttest HR and HR difference, there was both a significant weight-dependent and weight-independent mechanism. The effect of surgery on the risk of musculoskeletal pain occurred through a weight-independent mechanism.

Conclusions: Adolescents who underwent MBS experienced significant, durable improvement in mobility and pain, despite weight regain. Our models suggest that improvements may occur through a weight-independent mechanism.

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Conflict of interest statement

Justin R. Ryder receives support from Boehringer Ingelheim Pharmaceuticals in the form of drugs and placebos. Stephanie Sisley has received speaking and consulting fees from Rhythm Pharmaceuticals that are unrelated to this project. Marc P. Michalsky has received educational honoraria from Intuitive Surgical, Inc., and serves on a pediatric obesity advisory panel for Eli Lilly and Company, both unrelated to this project. Thomas H. Inge has served as consultant for Standard Bariatrics and Independent Medical Expert Consulting Services, both unrelated to this project. Anita P. Courcoulas has research support from Allurion Technologies and Eli Lilly and Company. The other authors declared no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Walk time in seconds and resting HR in bpm by visit with 95% CI values. bpm, beats per minute; HR, heart rate. [Color figure can be viewed at wileyonlinelibrary.com]
FIGURE 2
FIGURE 2
Immediate posttest HR, HR difference, and HR recovery by visit with 95% CI values. bpm, beats per minute; HR, heart rate. [Correction added on 21 May 2025, after first online publication: Figure 2 has been replaced for completeness.] [Color figure can be viewed at wileyonlinelibrary.com]
FIGURE 3
FIGURE 3
Modeled probability of any musculoskeletal pain by visit with 95% CI values. [Color figure can be viewed at wileyonlinelibrary.com]
FIGURE 4
FIGURE 4
Directed acyclic graph of the relationship between weight and functional mobility outcome.
See this image and copyright information in PMC

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References

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