Subscribe to RSS
DOI: 10.1055/a-2679-9676
Metabolic and Nutritional Outcomes After Sleeve Gastrostomy and Gastric Bypass in Adolescents: A Cohort Study with 1-Year Follow-Up
Authors
Supported by: School of Medicine, Shahid Beheshti University of Medical SciencesSchool of Medicine, Shahid Beheshti University of Medical Sciences 28897

Abstract
We conducted this study to compare the anthropometric and metabolic outcomes and nutritional status, after sleeve gastrostomy (SG) and gastric bypass (GB) in adolescents with severe obesity. We selected 219 adolescents with severe obesity (Body Mass Index>99th percentile or 95th≤BMI<99th percentile) among the participants of Tehran Obesity Treatment Study and assessed them for anthropometric and metabolic outcomes and nutritional status at baseline and during 1 year follow up after the surgery. Out of the total, 182 participants were in the SG group and 37 were in the GB group. BMI was lower in SG patients compared to GB group (38.5±4.8 kg/m 2 vs. 36.1±4.0 kg/m 2, p-value<0.05), 3 months after surgery. Metabolic profiles such as aspartate transaminase and alanine transaminase were lower in SG group compared to GB after 6 months of follow up, while high-density lipoprotein was higher in SG patients compered to GB patients (41.6±8.4 mg/dl vs. 48.0±9.2 mg/dl, p-value<0.05). After one year, total cholesterol and low-density lipoprotein were higher in adolescents who underwent SG compared to those in GB group. There was no significant difference in micronutrient status between SG and GB groups. It seems that SG in adolescents with obesity and fatty liver disease, is more appropriate but GB may be preferred in patients with a history of lipid profile abnormalities. More studies are needed to draw conclusions about nutritional status and long-term outcomes after surgery.
Publication History
Received: 28 April 2025
Accepted after revision: 02 August 2025
Article published online:
08 September 2025
© 2025. Thieme. All rights reserved.
Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
-
References
- 1 Moores CJ, Bell LK, Miller J. et al. A systematic review of community-based interventions for the treatment of adolescents with overweight and obesity. Obes Rev 2018; 19: 698-715
- 2 Sommer A, Twig G. The impact of childhood and adolescent obesity on cardiovascular risk in adulthood: a systematic review. Curr Diabetes Rep 2018; 18: 91
- 3 Tyson N, Frank M. Childhood and adolescent obesity definitions as related to BMI, evaluation and management options. Best Pract Res Clin Obstet Gynaecol 2018; 48: 158-164
- 4 Fryar CD, Carroll MD, Ogden CL. Prevalence of overweight, obesity, and severe obesity among children and adolescents aged 2–19 years: United States, 1963–1965 through 2015–2016 https://www.cdc.gov/nchs/data/hestat/obesity_child_15_16/obesity_child_15_16.pdf
- 5 Kelishadi R, Ardalan G, Gheiratmand R. et al. Thinness, overweight and obesity in a national sample of Iranian children and adolescents: CASPIAN study. Child Care Health Dev 2008; 34: 44-54
- 6 Bolling CF, Armstrong SC, Reichard KW. et al. Metabolic and bariatric surgery for pediatric patients with severe obesity. Pediatrics 2019; 144: e20193224
- 7 Ogden CL, Fryar CD, Hales CM. et al. Differences in obesity prevalence by demographics and urbanization in US children and adolescents, 2013-2016. JAMA 2018; 319: 2410-2418
- 8 Montastier E, du Rieu MC, Tuyeras G. et al. Long-term nutritional follow-up post bariatric surgery. Curr Opin Clin Nutr Metab Care 2018; 21: 388-393
- 9 Stanford FC, Mushannen T, Cortez P. et al. Comparison of short and long-term outcomes of metabolic and bariatric surgery in adolescents and adults. Front Endocrinol (Lausanne) 2020; 11: 157
- 10 Mannaerts G, Zengerink J, Grotenhuis B. et al. Laparoscopic sleeve gastrectomy versus gastric bypass in late adolescents: what is the optimal surgical strategy for morbid obesity?. Eur J Pediatr Surg 2016; 26: 487-493
- 11 Wu Z, Gao Z, Qiao Y, Chen F, Guan B, Wu L, Cheng L, Huang S, Yang J. Long-term results of bariatric surgery in adolescents with at least 5 years of follow-up: a systematic review and meta-analysis. Obesity Surgery. 2023 33. 1730-1745
- 12 Maffazioli GD, Stanford FC, Campoverde Reyes KJ. et al. Comparing outcomes of two types of bariatric surgery in an adolescent obese population: Roux-en-Y gastric bypass vs. sleeve gastrectomy. Front Pediatr 2016; 4: 78
- 13 Ahn SM. Current issues in bariatric surgery for adolescents with severe obesity: durability, complications, and timing of intervention. J Obes Metab Syndr 2020; 29: 4
- 14 Cozacov Y, Roy M, Moon S. et al. Mid-term results of laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass in adolescent patients. Obes Surg 2014; 24: 747-752
- 15 Inge TH, Courcoulas AP, Jenkins TM. et al. Weight loss and health status 3 years after bariatric surgery in adolescents. N Engl J Med 2016; 374: 113-123
- 16 Inge TH, Jenkins TM, Xanthakos SA. et al. Long-term outcomes of bariatric surgery in adolescents with severe obesity (FABS-5+): a prospective follow-up analysis. Lancet Diabetes Endocrinol 2017; 5: 165-173
- 17 Sugerman HJ, Sugerman EL, DeMaria EJ. et al. Bariatric surgery for severely obese adolescents. J Gastrointest Surg 2003; 7: 102-108
- 18 Alqahtani AR, Elahmedi M, Abdurabu HY. et al. Ten-year outcomes of children and adolescents who underwent sleeve gastrectomy: weight loss, comorbidity resolution, adverse events, and growth velocity. J Am College Surg 2021; 233: 657-664
- 19 van de Pas KG, Bonouvrie DS, Janssen L. et al. Roux-en-Y gastric bypass versus sleeve gastrectomy in young adults: a Dutch registry study. Obes Surg 2022; 32: 763-770
- 20 Xanthakos SA, Khoury JC, Inge TH. et al. Nutritional risks in adolescents after bariatric surgery. Clin Gastroenterol Hepatol 2020; 18: 1070-1081. e5
- 21 El Chaar M, King K, Al-Mardini A. et al. Thirty-day outcomes of bariatric surgery in adolescents: a first look at the MBSAQIP database. Obes Surg 2021; 31: 194-19
- 22 Pizza F, D’Antonio D, Lucido FS. et al. Does antrum size matter in sleeve gastrectomy? A prospective randomized study. Surg Endoscopy 2021; 35: 3524-3532
- 23 Pizza F, D’Antonio D, Lucido FS. et al. The role of ursodeoxycholic acid (UDCA) in cholelithiasis management after one anastomosis gastric bypass (OAGB) for morbid obesity: results of a monocentric randomized controlled trial. Obes Surg 2020; 30: 4315-4324
- 24 Pizza F, D’Antonio D, Lucido FS. et al. Postoperative clinical-endoscopic follow-up for GERD and gastritis after one anastomosis gastric bypass for morbid obesity: how, when, and why. Obes Surg 2020; 30: 4391-4400
- 25 Cunha FM, Oliveira J, Preto J. et al. The effect of bariatric surgery type on lipid profile: an age, sex, body mass index and excess weight loss matched study. Obes Surg 2016; 26: 1041-1047
- 26 Hosseini-Esfahani F, Khalaj A, Valizadeh M. et al. Nutrient intake and deficiency of patients 1 year after bariatric surgery: Tehran obesity treatment study (TOTS). J Gastrointest Surg 2021; 25: 911-918
- 27 Aryannezhad S, Hosseinpanah F, Khalaj A. et al. Comparison of the one-year outcomes of bariatric surgery in adolescents and young adults: a matched case-control study, Tehran obesity treatment study (TOTS). Surg Today 2021; 51: 1764-1774
- 28 Beamish AJ, Harper ER, Jarvholm K. et al. Long-term outcomes following adolescent metabolic and bariatric surgery. J Clin Endocrinol Metab 2023; 108: 2184-2192