Laparoscopic Sleeve Gastrectomy for Adolescents With Severe Obesity: Medium-Term Weight Outcomes and Mental Health Insights.

BACKGROUND

Metabolic bariatric surgery in adolescents is an evolving field, and data are limited in Australia. Surgery in this age group has special safety, social and ethical considerations. The impact of MBS on psychiatric, mental health and psychosocial wellbeing is poorly understood. We review the patient demographics, mental health conditions, weight outcomes, complications and follow-up of a cohort of adolescents who underwent laparoscopic sleeve gastrectomy (SG) by a single surgeon in a large volume clinic with an established adolescent multidisciplinary team program receiving patients from across Australia and New Zealand.

METHODS

A prospective bariatric database was retrospectively analysed to review the adolescents aged 13-19 who underwent a primary SG from December 2011 to December 2024. Patients who were a minimum of 6 months post-surgery were included.

RESULTS

Sixty-three patients aged 13-19 years old underwent primary SG. Median pre-operative weight and body mass index (BMI) were 123 kg and 42.1 kg/m2. Pre-operatively, 26 adolescents reported a psychiatric and/or mental health disorder, seven reported suicidal ideation or self-harm history and six reported experiencing severe weight-bullying. At 3 months, 6 months, 12 months and 2 years after SG, median BMI decreased to 33.6, 30.6, 27.5 and 28.1 kg/m2, respectively. Follow-up rates progressively decreased and were 42% at 2 years. There was no mortality and one staple line leak.

CONCLUSION

SG is a safe and promising option for the treatment of adolescents living with obesity in the short to medium-term. The high prevalence of mental health disorders and poor follow-up are major concerns. Long-term data with better follow-up is required in Australia.