Michael Helmrath · From adolescence to young adulthood: trajectories of psychosocial health following Roux-en-Y gastric bypass
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Article1 min read·Published Mar 2017Older

From adolescence to young adulthood: trajectories of psychosocial health following Roux-en-Y gastric bypass

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Article · Mar 2017 · 1 min read

In brief

In brief

This longitudinal study tracked 14 adolescents for 6+ years after Roux-en-Y gastric bypass, finding substantial initial weight loss and quality-of-life improvements that partially regressed over time. Mental health symptoms present before surgery often persisted into young adulthood, though no new psychiatric issues emerged postoperatively.

Written by the GCMD Library team from the article.

Michael Helmrath

Background: Roux-en-Y gastric bypass (RYGB) in adolescence results in substantial bodyweight reduction and cardiometabolic benefits into young adulthood. Knowledge gaps remain in understanding psychosocial health. Objective: Describe trajectories of weight and psychosocial health in adolescents who underwent RYGB into young adulthood. Setting: Academic Pediatric Medical Center. Methods: Fourteen adolescents (presurgery: mean body mass index = 59.2±8.9; mean age = 16.0±1.3 yr; 64.3% female) participated in 2 sequential observational studies. Height and weight were measured, and participants completed measures of weight-related quality of life (WRQOL), mental health, and adaptive functioning at presurgery and 6, 12, 18, 24, and 72+months postsurgery. Substance use behaviors were assessed at 72+months. Results: Modeling demonstrated rapid improvement in body mass index and WROQL across postoperative year 1, followed by stabilization and modest weight regain/WRQOL decline (P<.001), with 50% remaining severely obese. Presurgery, 11 adolescents presented with symptoms outside of the normal range for≥1 mental health domain. Postoperative profiles indicated either remittance (n = 5) or persistent symptomatology (n = 6: anxious/depressed, withdrawn/depressed, and/or thought problems) in young adulthood. No new incidence of mental health vulnerability occurred in young adults not already identified preoperatively. Adaptive functioning and substance use were within normal range. Conclus

Statements in this article

  1. Roux-en-Y gastric bypass in adolescence results in substantial bodyweight reduction and cardiometabolic benefits into young adulthood.

    EstablishedBackground
  2. The study cohort had a mean presurgery body mass index of 59.2±8.9 and mean age of 16.0±1.3 years, with 64.3% female participants.

    ResearchMethods
  3. Participants were assessed at presurgery and at 6, 12, 18, 24, and 72+ months postsurgery for height, weight, weight-related quality of life, mental health, and adaptive functioning.

    ResearchMethods
  4. Body mass index and weight-related quality of life showed rapid improvement across postoperative year 1, followed by stabilization and modest weight regain with quality of life decline (P<.001).

    ResearchResults
  5. At 72+ months postoperatively, 50% of participants remained severely obese.

    ResearchResults
  6. Presurgery, 11 adolescents presented with symptoms outside of the normal range for at least one mental health domain.

    ResearchResults
  7. Postoperative mental health profiles indicated either remittance in 5 participants or persistent symptomatology in 6 participants with anxious/depressed, withdrawn/depressed, and/or thought problems in young adulthood.

    ResearchResults
  8. No new incidence of mental health vulnerability occurred in young adults not already identified preoperatively.

    ResearchResults
  9. Adaptive functioning and substance use were within normal range at 72+ months postoperatively.

    ResearchResults

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