Meg H Zeller1, Emma C Pendery2, Jennifer Reiter-Purtill2, Sanita L Hunsaker2, Todd M Jenkins3, Michael A Helmrath3, Thomas H Inge4. 1. Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. Electronic address: Meg.Zeller@cchmc.org. 2. Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. 3. Division of Pediatric Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. 4. Division of Pediatric Surgery; Children's Hospital Colorado, Aurora, Colorado.
Abstract
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 Postoperative profiles indicated either remittance (n = 5) or persistent symptomatology (n = 6: anxious/depressed, withdrawn/depressed, and/or thought problems) in young adulthood.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. CONCLUSIONS: Although adolescent RYGB resulted in improvement in weight and WRQOL into young adulthood, mental health trajectories were more variable, with some experiencing positive change while others experienced persistent mental health vulnerability. Research focused on larger contemporary samples using a controlled design is critical to inform targets for prevention and intervention to optimize both physical and psychosocial health outcomes in this younger patient population.
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. CONCLUSIONS: Although adolescent RYGB resulted in improvement in weight and WRQOL into young adulthood, mental health trajectories were more variable, with some experiencing positive change while others experienced persistent mental health vulnerability. Research focused on larger contemporary samples using a controlled design is critical to inform targets for prevention and intervention to optimize both physical and psychosocial health outcomes in this younger patient population.
Authors: Meg H Zeller; Jennifer Reiter-Purtill; Megan B Ratcliff; Thomas H Inge; Jennie G Noll Journal: Surg Obes Relat Dis Date: 2011-03-05 Impact factor: 4.734
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Authors: Meg H Zeller; Gia A Washington; James E Mitchell; David B Sarwer; Jennifer Reiter-Purtill; Todd M Jenkins; Anita P Courcoulas; James L Peugh; Marc P Michalsky; Thomas H Inge Journal: Surg Obes Relat Dis Date: 2016-05-25 Impact factor: 4.734
Authors: Thomas H Inge; Anita P Courcoulas; Todd M Jenkins; Marc P Michalsky; Michael A Helmrath; Mary L Brandt; Carroll M Harmon; Meg H Zeller; Mike K Chen; Stavra A Xanthakos; Mary Horlick; C Ralph Buncher Journal: N Engl J Med Date: 2015-11-06 Impact factor: 91.245
Authors: Meg H Zeller; Avani C Modi; Jennie G Noll; Jeffrey D Long; Thomas H Inge Journal: Obesity (Silver Spring) Date: 2009-01-22 Impact factor: 5.002
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Authors: Claudia K Fox; Amy C Gross; Eric M Bomberg; Justin R Ryder; Megan M Oberle; Carolyn T Bramante; Aaron S Kelly Journal: Curr Obes Rep Date: 2019-09
Authors: Sanita L Hunsaker; Beth H Garland; Dana Rofey; Jennifer Reiter-Purtill; James Mitchell; Anita Courcoulas; Todd M Jenkins; Meg H Zeller Journal: J Adolesc Health Date: 2018-04-30 Impact factor: 5.012
Authors: Janey S A Pratt; Allen Browne; Nancy T Browne; Matias Bruzoni; Megan Cohen; Ashish Desai; Thomas Inge; Bradley C Linden; Samer G Mattar; Marc Michalsky; David Podkameni; Kirk W Reichard; Fatima Cody Stanford; Meg H Zeller; Jeffrey Zitsman Journal: Surg Obes Relat Dis Date: 2018-03-23 Impact factor: 4.734