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Marc Michalsky, MD


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John A. Bauer, Ph.D.


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Bariatric Surgery In Teens May Curb Cardio Risks

More than losing weight, small study finds big improvements in heart health

(COLUMBUS, Ohio) January 2013 –  A study by researchers at Nationwide Children’s Hospital has found that beyond losing weight, teenagers who undergo bariatric surgery might experience a considerable reduction in the risk of cardiovascular disease as well.

In a small study, researchers here found that, prior to undergoing weight loss surgery, some teenagers had enlarged hearts and cardiovascular disease on par with more middle aged patients.  But after surgery, those same teenagers saw dramatic improvements.

It’s estimated that nearly one out of five children and adolescents is obese in this country, three times as many as just a generation ago.

Doctors say for those who are extremely obese, surgery may be the only viable option to lose weight and keep it off.  And now, that approach could be far more beneficial than first thought.

The study appears in the January print issue of the Journal of Pediatric Surgery.

To learn more about the results of the study and to meet one teenager who opted for bariatric surgery, click on the video box to the left.

To read the full press release, click on “click to read more” link below.

 

 

Study: Bariatric Surgery in Extremely Obese Adolescents May Also Help Treat Previously Undiagnosed Cardiovascular Abnormalities

(COLUMBUS, Ohio) – This time of year many people make resolutions to live a healthier lifestyle, exercise more, lose weight and eat better. For the adolescents who are extremely obese in this country, diet and exercise alone often are not enough to get their weight down. Some of those teens will require weight loss surgery to improve their overall health. According to a recent study published in the January print issue of the Journal of Pediatric Surgery, bariatric surgery in extremely obese adolescents also was shown to be beneficial in helping to reverse previously undiagnosed cardiovascular abnormalities believed to be linked to severe obesity.

The study included a retrospective analysis of 10 adolescent patients (nine female) from Nationwide Children’s Hospital who underwent weight loss surgery between August and December 2008. High fidelity imaging using cardiac magnetic resonance (CMR) was performed on these patients in the months leading up to bariatric surgery and revealed heart abnormalities (such as increased left ventricular mass, left ventricular dilation, hypertension) in all patients.

“What we found was that the cardiac structure and function in these extremely obese adolescents scheduled for bariatric surgery, was much more impaired than one might have thought,” said study co-author John Bauer, PhD, principal investigator in the Center for Perinatal Research at The Research Institute at Nationwide Children’s Hospital. “In addition, more than half of the patients we looked at had significant cardiac abnormalities that would be on par with a middle-aged person with real cardiovascular disease risk in the short term.”

Within the first post-operative year (mean range of 7-13 months), patients were re-evaluated using CMR. Results showed that their previously recorded cardiovascular abnormalities were reversed.

“Many of the abnormalities that we documented during the initial baseline study showed significant improvement after the weight loss had been obtained,” said the study’s co-author Marc Michalsky, MD, surgical director of the Center for Healthy Weight and Nutrition at Nationwide Children’s Hospital. “This is a small, preliminary study that shows the significance of cardiovascular abnormalities in morbidly obese teens and that additional, more robust investigations are needed to understand how weight loss surgery can help this patient population.”

In the Center for Healthy Weight and Nutrition at Nationwide Children’s, patients first go through several months of evaluation to see if they are even candidates for weight loss surgery. This includes an introductory information session attended by the adolescent and parent and assessmentsof the potential candidate by a number of staff in the Center including dieticians, bariatric nurse practitioners, psychologists, physical therapists and surgeons. Candidates for weight loss surgery are those that have gone through several failed attempts at diet and exercise regiments. These teenagers have significant organ damage and their quality of life is poor, Dr. Michalsky said.

“Bariatric surgery in adolescents is never a cosmetic procedure,” explained Dr. Michalsky who is also a faculty member at The Ohio State University College of Medicine. “These teens are very sick, they are suffering and they can truly benefit in overall health from weight loss surgery.”

Nationwide Children’s is one of a few centers in the country involved in long-term clinical research of adolescent bariatric surgery, looking not only at what happens in the short-term post-surgery, but long-term as well.

 

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