Long-Term Outcomes of One-Anastomosis Gastric Bypass in Adolescents with Obesity

Overview

This study evaluated the safety and efficacy of one-anastomosis gastric bypass (OAGB) in 91 adolescents with severe obesity across two centers in Egypt and Lebanon. Significant improvements were observed in anthropometric measures, nutritional and metabolic parameters, and obesity-related comorbidities over a 4-year follow-up.

Background

Adolescent obesity is a major global health concern with long-term consequences. Metabolic and bariatric surgery (MBS), including OAGB, is an effective treatment for severe obesity in adults, but data in adolescents remain limited. Previous studies on OAGB in adolescents had small sample sizes, short follow-up, and limited assessment of metabolic and obesity-related conditions. This study aimed to address these gaps by assessing a larger cohort with comprehensive outcomes over multiple years.

Data Highlights

Key Findings

• OAGB resulted in significant and sustained reductions in weight, BMI, excess weight loss, and total weight loss over 4 years.
• Nutritional parameters including hemoglobin, vitamin B12, protein, albumin, and calcium remained stable postoperatively, indicating good nutritional status.
• Metabolic control improved significantly, with HbA1c levels decreasing and sustained remission of type 2 diabetes mellitus in affected patients.
• High rates of remission were observed for hypertension and other obesity-related conditions such as depression, polycystic ovary syndrome, and obstructive sleep apnea.
• The procedure was performed safely with low complication rates across two centers and countries, supporting its feasibility in adolescents.
• Year-on-year assessments showed maintenance of improvements without significant nutritional deficiencies or weight regain.

Clinical Implications

OAGB is a safe and effective surgical option for adolescents with severe obesity, providing durable weight loss and improvement or remission of obesity-related comorbidities. Careful preoperative evaluation and postoperative monitoring of nutritional and metabolic parameters are essential to ensure long-term safety. These findings support broader adoption of OAGB in pediatric bariatric practice with multidisciplinary management.

Conclusion

This multicenter study demonstrates that OAGB offers sustained weight loss, metabolic improvement, and comorbidity remission in adolescents with severe obesity, with a favorable safety profile. These results fill important knowledge gaps and support OAGB as a viable treatment option in this population.

References

1. American Diabetes Association/International Expert Committee/Various Authors -- Diagnostic Criteria and Remission Definitions for T2DM
2. IFSO Guidelines -- Indications for Metabolic and Bariatric Surgery in Adolescents
3. Previous Studies on OAGB in Adolescents (References 10,11,12)