Background

Laparoscopic sleeve gastrectomy is the most common bariatric procedure performed in the US, and is by far the most common bariatric operation performed in adolescents and young adults. There remains a paucity of data regarding long-term weight outcomes after sleeve gastrectomy in young patients, in whom durability of weight loss is paramount. This single-institution study reviews longitudinal weight data after laparoscopic sleeve gastrectomy in patients aged 25 years or younger.

Methods

We retrospectively reviewed records of all patients who underwent laparoscopic sleeve gastrectomy at our institution between 2013 and 2018. All weight data documented in the medical record through October 2022 was included. We calculated weight change postoperatively as percent total body weight loss (%TBWL) relative to preoperative weight.

Results

103 patients aged 25 years or younger underwent laparoscopic sleeve gastrectomy at mean age 22.9±2.4 years. 49.5% identified as African-American or Hispanic, 42.7% had private health insurance, and 60.2% had at least 4 years of available follow-up weight data. Mean %TBWL was 26.5±2.7% at weight nadir, which occurred at 1.3±0.2 years postoperatively. Mean longitudinal %TBWL was 11.3±3.3% at 5.7±0.3 years postoperatively, with 49 of the 62 patients (79%) regaining to within 20% of their preoperative weight.

Conclusions

Adolescents and young adults undergoing laparoscopic sleeve gastrectomy at our institution had weight nadir comparable to published results, but the majority developed significant weight regain. Our findings highlight the need for combined therapies at the time of postoperative nadir to enhance the long-term efficacy of sleeve gastrectomy in this diverse, publicly-funded population.