Teens Binge Before Bariatric Surgery

Teens Binge Before Bariatric Surgery
And more so when parents had procedure before them

Action Points
NATIONAL HARBOR, Maryland – Adolescents facing bariatric surgery tended to gain weight shortly before having the procedure, especially when they had seen a parent undergo such a procedure, researchers reported here.
About 74% of the children of parents who had bariatric surgery gained weight in the pre-operative period compared with 42% of the children who did not have a parent who had undergone bariatric surgery, reported Jennifer Robbins, MD, of the Nemours/A.I. duPont Hospital for Children in Wilmington, Delaware.

In her Quickshot oral presentation during Obesity Week 2017, Robbins said that overall there was a 2.1% weight gain during the run-up to surgery.
She said that children with a family history of bariatric surgery had an adjusted odds ratio of 5.3 (95% CI 1.4-19.2) of gaining more weight than the median before bariatric surgery. "This was the only significant finding in our study," she said.
In the study, 23 adolescents had parents who previously had bariatric surgery and 53 adolescents had parents without a bariatric surgical experience. Adolescents in the program were ages 14-18. They were enrolled in a prospective registry.
"We were trying to understand if having parents who had undergone bariatric surgery influenced outcomes related to weight and nutrition among adolescents in our program," Robbins said.
The researchers also measured pre-operative weight gain or loss as well post-operative weight loss which was measured at several time points over 2 years, controlling for demographics and type of surgery.

The ethnically diverse cohort was 79% female; 59.2% received a band procedure and 40.8% received sleeve gastrectomy surgery. About 54% of the patients were white; 29% were black; 7% were Hispanic. Mean body mass index at study entry was 49.3.
"Those who had sleeve surgery tended to lose more weight than those who had the band procedure, which was expected," Robbins said.
Patients were stratified according to whether they gained more or less weight than the median in the preoperative period and whether their parents had bariatric surgery.
Generally, Robbins said the study did support the idea that "bariatric surgery may be a good option for adolescents whose parents had bariatric surgery."
About half the children in the study dropped out. Numerically fewer dropouts – measured by loss of follow-up for more than 1 year – were in the group of children whose parents had the surgery, although the difference was not statistically significant.

After 2 years, 57% of the children whose parents had bariatric surgery had lost less than the median weight loss compared with 44% of the children whose parents did not have a parent with a bariatric surgery history – but that difference was not statistically significant either, Robbins said.
She said that the researchers have not yet figured out why the children gain more weight in the preoperative period if their parents had bariatric surgery. "People may have different expectations of weight loss based on whether their parents have had bariatric surgery. We are trying to measure that in a more standardized way right now," she said.
"This is a fascinating study," said session co-moderator Dana Telem, MD, of the University of Michigan at Ann Arbor.
"We often hear about the halo effect that bariatric surgery may have on the rest of the family. I think that what is going on with this increased weight gain is that the children have witnessed their parents undergoing the surgery and the food deprivation that goes along with the treatment and they decide to have one last binge before they have the same procedures," she told MedPage Today,
She suggested that the children may be loading up on pizza, ice cream, and other foods because they know what is coming and that these food choices may be less available to them in the future.
Obesity Week is sponsored by The Obesity Society and the American Society of Metabolic & Bariatric Surgery.