Background

There are limited data regarding weight nadir following laparoscopic sleeve gastrectomy (LSG) in adolescents and young adults. This single-institution study reviews longitudinal weight outcomes after LSG in patients aged 25 years or younger, with attention to timing of weight nadir and demographic variables associated with weight nadir.

Methods

We retrospectively reviewed records of patients who underwent LSG at our institution between 2013 and 2020, and included weight data through October 2022. We calculated weight nadir postoperatively as maximal percent total body weight loss (%TBWL) relative to preoperative weight.

Results

123 patients aged 25 years or younger underwent LSG (mean 22.9±2.3 years). 52.0% identified as African-American or Hispanic, 42.3% had private health insurance, and 56.9% had available weight nadir data. Overall, mean %TBWL was 27.6±2.3% at weight nadir, at 1.5±0.2 years postoperatively. Patients reaching nadir after 1 year postoperatively had significantly greater %TBWL at nadir (31.3±2.1%) than patients reaching nadir before 1 year postoperatively (18.6±2.8%, p < 0.001). Caucasian patients had significantly greater %TBWL at nadir (31.0±3.3%) than African-American patients (25.3±3.8%, p = 0.02) or Hispanic patients (23.6±4.1%, p < 0.01). There was no significant difference in %TBWL at nadir between patients with private and public health insurance (p=0.14).

Conclusions

Our results suggest that time to weight nadir and patient race/ethnicity are significantly associated with %TBWL at nadir following LSG in adolescent and young adult patients. Identifying variables associated with weight nadir can help set expectations about combined therapies and inform timing of adjunct weight loss interventions in this population.