Background

Bariatric surgery has proven to be the most effective treatment for severe obesity in adults and has shown promising results in young adults. However, due to concerns regarding long-term efficacy and complications the utilization of bariatric surgery in young adults lags behind that of adults. Therefore, this study aimed to compare weight loss outcomes between young adults and adults who underwent a Roux-en-Y Gastric Bypass(RYGB) or sleeve gastrectomy(SG).

Methods

A nationwide population-based cohort study utilizing data from the Dutch Audit Treatment of Obesity(DATO). Young adults(aged 18-25) and adults(aged 35-55) who underwent primary RYGB or SG were included. Primary outcome was percentage total weight loss(%TWL) until five years postoperatively. Secondary outcomes were incidence of complications and regression of obesity related comorbidities.

Results

A total of 2,822(10.3%) young adults and 24,497(89.7%) adults were included. Young adults more often received a SG(45.8% versus 22.9%; p<0.001) and had a higher preoperative BMI compared to adults(44.4±4.9 versus 42.8±5.2; p<0.001). Young adults who underwent RYGB showed superior percentage TWL compared to adults until four years postoperatively(Figure 1a). Young adults who underwent SG revealed superior percentage TWL until five years postoperatively(Figure 1b). Postoperative complications ≤30 days were more prevalent among adults, 5.3% versus 3.5%(p<0.001). No differences were found in the long term complications. Young adults revealed more improvement of hypertension, dyslipidemia and musculoskeletal pain.

Conclusions

Bariatric surgery appeared to be safe and effective in young adults. Compared to adults, superior weight loss and improvement of obesity related comorbidities were found in the short- and midterm.