Long-Term Cardiometabolic Outcomes After Adolescent Sleeve Gastrectomy
Overview
This 9-year follow-up study evaluated adolescents undergoing primary laparoscopic sleeve gastrectomy (LSG) for severe obesity. Significant long-term improvements were observed in weight loss and cardiometabolic parameters including remission of type 2 diabetes, hypertension, and dyslipidemia.
Background
Severe adolescent obesity is linked to early onset of type 2 diabetes, hypertension, dyslipidemia, and other metabolic risks that reduce lifespan. Conventional lifestyle and pharmacological interventions yield limited long-term success. Bariatric surgery, particularly LSG, has shown promising short- and mid-term benefits, but data on its durability beyond 5 years in adolescents remain scarce. This study addresses this gap by assessing anthropometric and cardiometabolic outcomes up to 9 years post-LSG.
Improved blood pressure, lipid profile, glucose control
Early remission of T2DM, HTN, dyslipidemia observed
3
Maintained weight loss
Continued improvement in cardiometabolic markers
Increased rates of comorbidity remission
5
Sustained weight loss with some weight regain in subset
Stable cardiometabolic improvements
Durable remission of T2DM, HTN, dyslipidemia
7
Weight loss largely maintained
Cardiometabolic parameters remain improved
Long-term remission sustained
9
Weight loss durable in majority
Cardiometabolic benefits persist
Remission of comorbidities sustained in most patients
Key Findings
Adolescents undergoing LSG achieved significant and sustained weight loss over 9 years, with mean BMI reductions maintained at all follow-up points.
Cardiometabolic parameters including blood pressure, lipid profiles, fasting glucose, and HbA1c showed marked improvement post-surgery and remained stable long term.
High rates of remission were observed for type 2 diabetes, hypertension, and dyslipidemia, consistent with ASMBS remission criteria.
Weight regain occurred in a minority but did not negate overall cardiometabolic benefits.
LSG was performed safely with low rates of revisional surgery (2.7%) and minimal perioperative complications.
Multidisciplinary care including nutritional and physical activity counseling supported sustained outcomes.
Clinical Implications
LSG is an effective long-term treatment option for severe adolescent obesity, producing durable weight loss and remission of key cardiometabolic comorbidities. Early surgical intervention combined with comprehensive multidisciplinary follow-up can improve long-term health trajectories in this high-risk population. Clinicians should consider LSG in adolescents meeting BMI and comorbidity criteria when lifestyle and pharmacologic therapies are insufficient.
Conclusion
This study demonstrates that primary laparoscopic sleeve gastrectomy in adolescents yields sustained weight loss and durable remission of cardiometabolic risk factors up to 9 years postoperatively. These findings support the role of LSG as a valuable long-term therapeutic strategy for severe adolescent obesity.
References
ASMBS Guidelines 2016 -- Bariatric Surgery Comorbidity Remission Criteria
Hamad Medical Corporation IRB Protocol #16308116 -- Study Approval
Previous studies 2011-2015 -- Adolescent Bariatric Surgery Outcomes
