Rationale: Although many adolescents meet the NICE criteria for bariatric surgery in the UK, there is a reluctance to undertake or commission irreversible procedures in young people. Balloons are temporary, reversible, safer and in adults have been shown to promote a clinically significant change in BMI of between 4.0 and 9.0 kg/m2. However due to subsequent weight regain, bypass surgery is preferred in adults. In adolescents, more amenable to change, balloons may potentially be more effective.
Objectives: i) To assess the efficacy of the intragastric balloon ( in situ for 6 months) supported by a lifestyle intervention to promote weight loss in severely obese adolescents. ii) To assess the impact of the weight loss on biomedical outcomes such as glucose metabolism, lipid profiles, bone density and architecture, and on psychosocial health.
Methodology: A cohort study of 12 adolescents (BMI >3.5 SD, Tanner stage 4 or above) with a 2-year follow up. All subjects took part in a comprehensive medical assessment including OGTTs, measurement of basal and stimulated incretins, bone turnover markers, DEXA scans and high resolution peripheral quantitative CT scans at 0.6 and 24 months.
Results: Twelve young people (seven girls) were recruited. The median age, weight, BMI and BMI SDS were 15.7 years, 136.55 kg (range 107.6178.9), 46.6 kg/m2 (range 39.256.3) and +4.1 (range 3.64.5) respectively. Mean weight loss at 6 months (balloon removal) was 7.1 kg, whilst the mean weight loss was 5% of total body weight (range −12.7% to 1%). Balloon removals were completed in March 2014 and 24-month follow up is on-going. Improvement in co-morbidities (blood pressure and insulin resistance) and in quality of life was been noted. Bone density was unaffected.
Funding: CLAHRC-Collaboration for Leadership in Applied Health Research and Care for South YorkshireBSPED-British Society of Paediatric Endocrinology and Diabetes.
01 Oct 2015 - 03 Oct 2015