Sleeve gastrectomy in adolescents: Weight loss at the expense of bones

SG is an effective weight-loss intervention in obesity. But bone density reduction often ensues post-surgery. What are the effects for young patients?

What you should know from the study on sleeve gastrectomy and its effects on bone density:

Study included adolescents and young adults with obesity that underwent SG or no surgery.
After 12 months, a CT of the lumbar spine and an MRI of the abdomen and thigh were performed.
There was significantly greater weight loss in the SG group, but also a marked deterioration in bone density.

Adolescents with obesity: an increasingly relevant topic

Morbid obesity is on the rise. In Western nations in particular, more and more young people are suffering from obesity types that requires treatment. Dietary measures often do not lead to the desired success. In some cases, bariatric surgery is necessary to achieve long-term weight reduction. One option is sleeve gastrectomy (SG).

In adults, SG is associated with a reduction in bone density. A recent study has investigated the effects of this surgery on the bones of adolescents and young adults.

Sleeve gastrectomy: what does it mean for young bodies?

The study authors compared the weight and bone density outcomes of young people with obesity requiring treatment. To do this, they created two groups: the first group had an SC, while the second group was a control group without surgery.

At the beginning of the study and after 12 months, all participants underwent a CT scan of the lumbar spine and an MRI of the abdomen and thigh. This was used to assess body composition, bone density and mobility.

Weight loss at the expense of bones?

The results should come as little surprise to most practitioners: there was a significant weight loss in the SG group, while weight in the control group remained unchanged. In addition, SG patients were able to achieve a significant reduction in abdominal fat, although this went hand in hand with a loss of muscle mass in the thighs.

When assessing bone density and mobility, those who had SG had poorer outcomes. Density and mobility were statistically significantly lower than in the control group.

A sleeve gastrectomy leads (unsurprisingly) to significant weight loss. However, a risk-benefit assessment must be carried out, particularly in adolescents and young adults, as the bones can suffer significantly from the consequences of the operation.

Source

Huber FA, Singhal V, Tuli S, Stanford FC, Carmine B, Bouxsein ML, Misra M, Bredella MA. Biomechanical CT to Assess Bone After Sleeve Gastrectomy in Adolescents With Obesity: A Prospective Longitudinal Study. J Bone Miner Res. 2023 Jul;38(7):933-942.