Objective:

To evaluate the 10-year cost-effectiveness of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy compared with no surgery for adolescents with severe obesity.

Key Findings:

• The prevalence of severe obesity among children aged 2 to 18 years increased significantly from 2008 to 2023.
• Intensive health behavior and lifestyle treatment often yields limited long-term success for severe obesity.
• RYGB and sleeve gastrectomy resulted in average BMI reductions of 20.6% and 19.2%, respectively, at 10 years postoperatively.
• Remission rates for type 2 diabetes, hypertension, and dyslipidemia ranged from 50% to 60% following surgery.
• **Interpretation:** The study underscores the escalating issue of severe obesity in adolescents, indicating that traditional non-surgical interventions may be insufficient for long-term weight management. The significant reductions in BMI observed with RYGB and sleeve gastrectomy suggest that these surgical options can be effective in achieving substantial weight loss. Additionally, the reported remission rates for obesity-related comorbidities like type 2 diabetes, hypertension, and dyslipidemia highlight the potential health benefits of these surgical interventions, reinforcing the importance of considering surgical options for adolescents who have not succeeded with conventional treatment methods.
• **Limitations:**
• Limited long-term cost-effectiveness data for metabolic and bariatric surgery in adolescents.
• Relapse of type 2 diabetes was not incorporated in the model due to insufficient data. -

Interpretation:

Remove this section.

Limitations:

• Limited long-term cost-effectiveness data for metabolic and bariatric surgery in adolescents.
• Relapse of type 2 diabetes was not incorporated in the model due to insufficient data. - -

Conclusion:

The findings suggest that RYGB and sleeve gastrectomy can be effective interventions for adolescents with severe obesity, leading to significant improvements in BMI and remission of obesity-related conditions. However, further research is needed to fully understand the long-term cost-effectiveness and potential risks associated with these surgical options in the adolescent population. ---

Sources:

• Teen-LABS Study