TY - JOUR
T1 - From adolescence to young adulthood
T2 - trajectories of psychosocial health following Roux-en-Y gastric bypass
AU - Zeller, Meg H.
AU - Pendery, Emma C.
AU - Reiter-Purtill, Jennifer
AU - Hunsaker, Sanita L.
AU - Jenkins, Todd M.
AU - Helmrath, Michael A.
AU - Inge, Thomas H.
N1 - Publisher Copyright:
© 2017 American Society for Bariatric Surgery
PY - 2017/7
Y1 - 2017/7
N2 - 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 Postoperative profiles indicated either remittance (n = 5) or persistent symptomatology (n = 6: anxious/depressed, withdrawn/depressed, and/or thought problems) in young adulthood.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.
AB - 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.
KW - Adolescent
KW - Bariatric surgery
KW - Psychosocial
KW - Young adult
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U2 - 10.1016/j.soard.2017.03.008
DO - 10.1016/j.soard.2017.03.008
M3 - Article
C2 - 28465159
AN - SCOPUS:85018346806
SN - 1550-7289
VL - 13
SP - 1196
EP - 1203
JO - Surgery for Obesity and Related Diseases
JF - Surgery for Obesity and Related Diseases
IS - 7
ER -
