Young people keep bariatric results more than 10 years after procedure

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Young people and adolescents who underwent bariatric surgery to control obesity managed to maintain the results for more than 10 years after the procedure, according to an American study published in the Journal of the American College of Surgeons.

According to the study, in addition to weight loss, patients were able to control hypertension, diabetes, depression and other comorbidities associated with obesity.

The study was based on the follow-up of 96 patients who underwent bariatric surgery in the United States when they were up to 21 years old (mean age was 19 years old) between 2002 and 2009. The BMI (body mass index) of these young people was about of 44.7 – which is already considered severe obesity – and the average weight was 126 kg.

Almost all of them (90%) were operated on using the gastric bypass technique, which reduces the size of the stomach by stapling and bypassing part of the intestine. The rest used the gastric band, which uses a ring-shaped device on the upper part of the stomach.

The doctor responsible for the surgeries returned to look for patients for a teleconsultation at least ten years after the procedure. Thus, they reported their current weight, the lowest weight they reached after surgery and how the other comorbidities were – including diabetes, hypertension, depression, sleep apnea. The professional also asked if these people were in any relationship, if they were married and if they had children.

According to the research, patients who underwent bypass lost, on average, 31% of their body weight, while those who underwent gastric banding lost 22%. In addition, all participants who had hyperglycemia, diabetes and asthma before surgery reported complete remission of these comorbidities and improvement in anxiety and depression.

For the researchers, the results demonstrate that these young people lead a normal life, and support the idea that surgery is safe and can be an alternative treatment for obesity in this population.

Problem also exists in Brazil

In Brazil, the number of adolescents and young people who are overweight or obese is increasing, which worries specialists. Data from the 2019 National Health Survey show that 19.4% of adolescents between 15 and 17 years old are overweight and 6.7% are obese. Among young adults aged 18 to 24, this number is even more alarming: 33.7% are overweight and 10.7% are obese.

The World Health Organization (WHO) estimates that by 2025 the world will have at least 75 million obese children and adolescents.

According to bariatric surgeon Adilon Cardoso Filho, from Hospital Israelita Albert Einstein in Goiânia, Brazil practically no longer uses the gastric band technique because of the poor long-term results. On the other hand, it is the country that most performs the bypass.

Cardoso says that this research demonstrates the satisfactory effect of surgery in the long term, but emphasizes that consistent results are only lasting when the patient receives good psychological and medical guidance during the pre-surgical period and is aware and mature about the process to which he is going. submit.

“If the patient is well informed about everything that will happen in a year, two years, five years, he will ‘sign’ this contract and five, ten, fifteen years will pass and he will be in full health, many times healthier than friends who are thin. But for that to happen, the bargaining chip is his commitment to maintain this result in the long term”, highlights the professional, remembering that surgery alone does not work miracles.

Another important point, says Cardoso, is that in order to maintain the satisfactory effects of the surgery in the long term, the decision to operate must have come from the patient himself and not from a family member.

“Obesity is a disease, obesity has ICD [sigla que classifica as doenças internacionalmente]🇧🇷 The person has to be aware of their condition and want to change their lives to maintain the results. If she operates under pressure from others, over time she will not be able to maintain the effects”, points out the doctor.

According to Cardoso, the medical follow-up protocol after bariatric surgery includes evaluation after one week of the procedure, one month, three months and one year. Depending on the results of the last exams, the patient should continue with biannual or annual follow-up.

In addition, the doctor establishes five commandments for the operated:

  • not drink alcohol
  • Don’t eat sweets (it’s not forbidden, but it shouldn’t be a routine)
  • relearn to chew
  • Discipline to eat five times a day
  • “Marry” the doctor who operated on him, maintaining constant monitoring

At the end of five years, the patient should reach the set point (average weight) and may have a small weight regain. “But the quality of life will have improved immensely,” she says.

For Cardoso, if there is no focus on changing eating habits since childhood, obesity in the country (and in the world) will only get worse.

“Treating obesity is complex and the numbers are increasingly alarming. Comorbidities may not appear in adolescence, but they will come later. It is necessary to attack obesity not when the patient is already obese. It is necessary to prevent it from childhood”, points the doctor.

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