Bariatric surgery offers sustained weight loss for adolescents with severe obesity, but long-term data on its effectiveness is limited. Our objective was to compare outcomes in adolescents who underwent bariatric surgery versus those who received nutritional intervention. We conducted a retrospective cohort study of individuals under 18 who underwent bariatric surgery within between 2011 and 2021. A comparison group included adolescents with class II obesity or higher and who had ≥ 3 dietitian visits. Anthropometric measures and blood test results (hemoglobin, TSH, vitamin D, folic acid, B12) were collected over five years. Multivariate linear mixed models assessed group differences over time. The cohort included 278 adolescents: 152 in the surgery group and 126 in the nutritional group. Over five years, BMI decreased from 44 to 32 in the surgery group but remained largely unchanged in the nutritional group (45.5 to 44), p < 0.001. At year 5, the surgery group had lower hemoglobin (12.45 vs. 13.46, p < 0.001) and declining B12 levels (p < 0.001). TSH levels decreased modestly in both groups, more so in the surgery group (p = 0.04). Bariatric surgery in adolescents led to significant, sustained BMI reductions but was associated with declines in some nutritional markers, highlighting the need for ongoing monitoring. • Bariatric surgery in adolescents with severe obesity proved effective in reducing weight and BMI, compared to nutritional intervention. • In the five-year period after bariatric surgery, adolescents had markedly lower levels of hemoglobin, vitamin B12, and TSH. • Micronutrient deficiencies are a potential risk of bariatric surgeries, requiring long-term monitoring and supplementation.
Reuveni et al. (Sat,) studied this question.