Background

Metabolic and bariatric surgery (MBS) is an effective treatment for severe obesity. Yet, research on predictors of MBS outcomes in adolescents is limited. Thus, there is a critical need to identify pre-surgical factors that predict health outcomes and comorbidity resolution in youth.

Methods

This longitudinal study examined psychological, cognitive, and familial factors in 12-18-year-olds undergoing laparoscopic sleeve gastrectomy. Participants were recruited from the Stanford Children’s Health Adolescent Bariatric Surgery Clinic from May 2020 to August 2021. Participants completed pre-MBS (baseline) and six-months post-MBS procedures assessing psychological functioning and loss of control (LOC) eating. Anthropometric data was collected from the electronic medical record.

Results

Twenty-one adolescents (M ± SD: 15.9 ± 2.00 years; 48.45 ± 5.95 kg/m2; 57% female; 57% Hispanic) provided baseline data and twenty adolescents completed six-month follow-up (95%). At baseline, one-quarter of the sample (n=5) reported LOC eating in the prior month. Depression (n=11; 52.4%) and anxiety (n=7; 33.3%) were commonly reported. Post-MBS, LOC eating (n=2; 9.5%) and anxiety (n=0; 0%) decreased. Depression levels remained elevated (n=12; 57.1%). Baseline depression and anxiety were not correlated with total weight loss (r’s=.06-.38). Adolescents with LOC eating pre-surgery had greater total weight loss compared to adolescents without LOC eating (26.3% versus 19.1%; Cohen’s d=-1.28, CI: -2.375, -0.161).

Conclusions

Anxiety levels and LOC eating decreased at 6-months following MBS in adolescents, however no change in depression was noted. Future studies are needed to identify pre-surgery interventions to improve MBS outcomes in youth.