Uriel Fennig1,2, Avigal Snir3, Irit Halifa-Kurzman3, Adi Sela3, Arie Hadas3, Silvana Fennig3,4. 1. Department of Child and Adolescent Psychiatry, Schneider Children's Medical Center of Israel, Petach-Tikwa, Israel. urifennig@gmail.com. 2. Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel. urifennig@gmail.com. 3. Department of Child and Adolescent Psychiatry, Schneider Children's Medical Center of Israel, Petach-Tikwa, Israel. 4. Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Abstract
INTRODUCTION: Adolescent obesity is markedly increasing worldwide and bariatric surgery is emerging as an effective treatment option. However, a subset of patients fails to achieve significant weight loss or show post-surgical weight regain. Efforts have been made to identify different post-surgical weight trajectories and their possible predictors. Furthermore, the role of pre-surgical intervention programs in optimizing post-surgical results has been a subject of debate. OBJECTIVES: This study aimed to evaluate the impact of a 3-month lifestyle-oriented pre-surgical program for adolescent candidates for bariatric surgery on pre-surgical weight loss (body mass index (BMI) on completion - BMI at admission), and to identify predictors of different post-surgical weight loss trajectories. METHODS: Forty-eight adolescent bariatric surgery candidates were enrolled in a lifestyle- and behavior-oriented bariatric program consisting of a 3-month pre-surgical outpatient intervention and a 6-month post-surgical follow-up. RESULTS: Mean BMI decreased by 1.82 points (SD = 1.83) during the program's pre-surgical intervention phase, a 3.8% average drop in participants' BMI; post-surgical weight loss trajectories were significantly associated in a curvilinear model with pre-surgical weight loss; optimal post-surgical results were associated with moderate pre-surgical weight loss, and inversely associated with maternal history of obesity, early-life weight loss attempts, and comorbid learning disorders. CONCLUSIONS: Moderate weight loss in a pre-surgical lifestyle-oriented intervention program predicts optimal post-surgical weight loss. Additionally, by assessing risk factors and pre-surgical weight loss patterns, it may be possible to identify sub-populations of adolescents undergoing bariatric surgery at risk of achieving sub-optimal long-term results.
INTRODUCTION: Adolescent obesity is markedly increasing worldwide and bariatric surgery is emerging as an effective treatment option. However, a subset of patients fails to achieve significant weight loss or show post-surgical weight regain. Efforts have been made to identify different post-surgical weight trajectories and their possible predictors. Furthermore, the role of pre-surgical intervention programs in optimizing post-surgical results has been a subject of debate. OBJECTIVES: This study aimed to evaluate the impact of a 3-month lifestyle-oriented pre-surgical program for adolescent candidates for bariatric surgery on pre-surgical weight loss (body mass index (BMI) on completion - BMI at admission), and to identify predictors of different post-surgical weight loss trajectories. METHODS: Forty-eight adolescent bariatric surgery candidates were enrolled in a lifestyle- and behavior-oriented bariatric program consisting of a 3-month pre-surgical outpatient intervention and a 6-month post-surgical follow-up. RESULTS: Mean BMI decreased by 1.82 points (SD = 1.83) during the program's pre-surgical intervention phase, a 3.8% average drop in participants' BMI; post-surgical weight loss trajectories were significantly associated in a curvilinear model with pre-surgical weight loss; optimal post-surgical results were associated with moderate pre-surgical weight loss, and inversely associated with maternal history of obesity, early-life weight loss attempts, and comorbid learning disorders. CONCLUSIONS: Moderate weight loss in a pre-surgical lifestyle-oriented intervention program predicts optimal post-surgical weight loss. Additionally, by assessing risk factors and pre-surgical weight loss patterns, it may be possible to identify sub-populations of adolescents undergoing bariatric surgery at risk of achieving sub-optimal long-term results.
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