ESPE Abstracts

Summary: Severe obesity with various complications is a growing public health problem in childhood. Due to the lack of available hygienic and dietary therapeutic solutions, bariatric surgery has become, in recent years, one of the only effective treatments for severe obesity to induce persistant weight loss and reduce complications.

Material and method: We analyzed a cohort of 162 patients followed in the specialized obesity center of South Paris between 2012 and 2021. We retrospectively analyzed anthropometric parameters and obesity complications before and after bariatric surgery (6 and 18 months) in 95 patients. The primary objective of the study was to assess the effectiveness of the procedure on weight loss and reduction of metabolic, mechanical and psychological complications in non-mature subjects who had completed their growth. We defined minimal, moderate and severe complications in accordance with French recommendations. Psychological complications were monitored according to a self-reported quality score established in the adolescent department. The secondary objective of the study was to evaluate the safety of performing this surgery in this population.

Results: We analyzed 95 patients, with a median age of 17 years. Surgery resulted in a decrease in BMI of 10kg/m² [24,1-60,7] at 6 months and an additional of 5kg/m² [22,5-45,9] at 18 months in the study population. After surgery, complications had regressed in more than half of the patients: 44.2% of patients still had a complication of their obesity, of which 25.2% were minimal complications, 10.5% moderate complications and 8.42% severe complications. 36.84% of patients had no further complications of their obesity, 18 months after surgery. We observed significant efficacy on mechanical and psychological complications in the population. We also found the safety of this surgery in adolescents when performed by trained surgeons because only 1 patient out of the 95 operated required a revision surgery.

Conclusion: Bariatric surgery has shown promising results in terms of safety and efficacy on weight loss and reduction of complications for severe juvenile obesity. Our study confirms this efficiency with a significant weight loss at 18 months after surgery. The early realization of this intervention has shown its value on reducing moderate and severe complications for these adolescents who have failed multiple hygienic and dietary measures and develop early metabolic complications. Meanwhile the proof of effectiveness of pharmacologic therapies in child, bariatric surgery is a safe and effective solution to prevent the development of severe complications of adult obesity for these patients.