A major study published today shows that teenagers who undergo surgery to treat their severe obesity are still reaping benefits a decade later. The research found that these individuals tend to keep a substantial amount of weight off, while many have continued to avoid obesity-related conditions like type 2 diabetes and hypertension.
Even in the wake of newer GLP-1 medications like semaglutide (Ozempic and Wegovy), bariatric surgery is still considered the most effective treatment for obesity, with patients losing up to 30% of their baseline weight. Studies have found these surgeries can also improve people’s health in many other ways, such as by sending their type 2 diabetes into remission or by lowering their risk of an early death. But this research has focused almost entirely on adults, making the new findings from this long-running study all the more important.
The Teen-LABS (Longitudinal Assessment of Bariatric Surgery) study first began in 2003 and is funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). In the earlier phases of the project, researchers tracked the health of thousands of teens who first got surgery for their severe obesity sometime between 2005 to 2009. In this latest follow-up, published Wednesday in the New England Journal of Medicine, they were able to look at the weight- and health-related outcomes of 260 patients a decade after their surgery—something that’s actually never been done before.
“This is the longest adolescent bariatric surgery follow-up study, with prior studies being 5 years or less,” lead study researcher Justin Ryder, Vice Chair of Research for the Department of Surgery at Ann & Robert H. Lurie Children’s Hospital of Chicago, told Gizmodo. “We now can show that the long term implications of performing obesity treatment using surgical methods in adolescents have tremendous long-term outcomes and great success.”
Overall, patients have maintained an average 20% weight loss, the researchers found. Of those who were diagnosed with type 2 diabetes at the time, 55% have still remained in remission. There was also a 54% sustained reduction in cases of high blood pressure and high cholesterol.
Plenty of other studies have found that bariatric surgery can have long-term benefits for adult patients, too. But based on these results, it appears that younger patients are more likely to experience these benefits years later (rates of continued diabetes remission are lower in adults, for instance). That suggests, Ryder said, that successfully treating obesity with surgery “sooner in the lifespan has its advantages.”
Like any medical treatment, bariatric surgery has its risks and potential negatives. There are different types of bariatric surgery, but they generally work by resculpting a person’s digestive system, such as by removing part of a person’s stomach. As a result, people’s lifestyles, particularly their diets, tend to dramatically change following surgery. People have to make sure they’re getting enough nutrients, for instance, since certain vitamins and minerals aren’t as easily absorbed through food anymore. They’re also more susceptible to alcohol abuse, since their stomachs are less proficient at breaking it down. Additionally, at least in the short term, patients may have a higher risk of suicide and self harm. And some people (perhaps about one in ten) will fail to lose or regain their weight back.
That being said, it has been about two decades since the original teen-LABS study began. Since that time, bariatric surgeries have only became safer and less invasive. So it’s possible that the positives of surgery, particularly for people with severe obesity or related conditions like type 2 diabetes, are even greater than the negatives today.
One interesting unknown is whether these long-term benefits can translate over to other treatments. GLP-1 medications like semaglutide and tirzepatide are the first drugs to clearly approach the average weight loss success seen with surgery, and newer drugs in the near future may even match or surpass it. Ryder cautions that any comparisons right now are difficult to make, however, since there haven’t been any studies yet that have directly pitted these drugs against surgery.
Both drugs and surgery have their place in obesity treatment, Ryder says, noting that many people who have surgery may still benefit from medication as well. Given the findings of this study and others, the key lesson here is that teenagers struggling with obesity should have more access to effective treatments in general, he adds—a change that other obesity experts have started to push for in recent years as well.
“It is important to understand that both medications and surgery need to be used more in adolescents as the impact is much better than traditional treatments such as lifestyle modification in this population,” he said.
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