<div><p>NEW YORK (Reuters Health) - When it comes to weight-loss surgery for very obese adolescents, having the surgery sooner rather than later may yield a better long-term outcome, new study findings hint.</p><p>Surgical treatment for extreme obesity may be appropriate for some adolescents, Dr. Thomas H. Inge, of Cincinnati Children's Hospital Medical Center, Ohio, and colleagues note in the Journal of Pediatrics.</p><p>Based on their experience, Inge told Reuters Health, "the timing of surgery for adolescent obesity is an important consideration, as 'late' referral for (weight-loss) surgery at higher body mass index (BMI) values may preclude reversal of obesity or extreme obesity within the first post-operative year and may increase the risk of weight regain over the long term."</p><p>But regardless of body weight going into the surgery, weight-loss surgery improves cardiovascular risk factors and brings body weight down significantly in all patients, the study team found.</p><p>BMI -- calculated by dividing weight in kilograms by height in meters squared -- is a standard way to determine how fat or thin a person is. Values between 20 and 25 are typically considered normal. Any value of 30 or greater is considered obese. Morbidly obese people have a body mass index (BMI) of 40 or greater -- equal to being about 100 pounds or 50 kilograms overweight.</p><p>To determine the effect of pre-surgery BMI status on outcomes in their younger patients, Inge's team followed 61 adolescents for a year after they underwent the most common and most effective form of weight-loss surgery for severe obesity called Roux-en-Y gastric bypass.</p><p>The procedure involves stapling off the upper portion of the stomach to create a small pouch that restricts the amount of food a person can eat at one time. The surgeon also makes a bypass from the pouch that skirts around the rest of the stomach and a portion of the small intestine, limiting the body's absorption of nutrients.</p><p>Inge's team stratified the adolescents in their study into three groups based on their pre-surgery BMI. Group 1 consisted of 23 patients with a BMI between 40.0 and 54.9. Group 2 consisted of 21 individuals with a BMI between 55.0 and 64.9, and Group 3 consisted of 17 individuals whose BMI fell between 65.0 and 95.0.</p><p>The average BMI in the overall cohort, which was 60.2 at the time of surgery, fell by roughly 37 percent at 1 year after surgery, with little variation in BMI reduction among the groups, the investigators report.</p><p>It is noteworthy, the investigators say, that subjects in Group 1 -- who had the lowest BMI going into the surgery -- had the lowest BMI a year after the surgery. Still, only 10 patients (17 percent) achieved a BMI of less than 30 at 1 year. Eight of these 10 were from Group 1.</p><p>"In this investigation, we found that most adolescents within the highest ranges of baseline BMI...remained extremely obese...despite BMI reductions averaging nearly 40 percent," the investigators note.</p><p>Adolescents "who present at higher weights and BMI values lose more weight than those who present at lower weights but also plateau at a higher weight on average," they add. "The biological and potentially behavioral reasons for this are unclear."</p><p>Regardless of pre-surgery BMI, weight-loss surgery led to a healthy reduction in blood pressure, cholesterol levels and triglycerides (harmful blood fats).</p><p>SOURCE: The Journal of Pediatrics, January 2010.</p><img src="http://admatch-syndication.mochila.com/images/ad.gif?aid=66113731&bid=informcom" /></div><div id="copyright"><div>

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