Two-year outcome of laparoscopic Roux-en-Y gastric bypass in adolescents with severe obesity: results from a Swedish Nationwide Study (AMOS)
CONTEXT: The prevalence of obesity among adolescents has increased and we lack effective treatments. OBJECTIVE: To determine if gastric bypass is safe and effective for an unselected cohort of adolescents with morbid obesity in specialized health care. DESIGN, SETTING AND PATIENTS: Intervention stud...
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| Veröffentlicht in: | INTERNATIONAL JOURNAL OF OBESITY 2012-11, Vol.36 (11), p.1388-1395 |
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| creator | Olbers, T Gronowitz, E Werling, M Mårlid, S Flodmark, C-E Peltonen, M Göthberg, G Karlsson, J Ekbom, K Sjöström, L V Dahlgren, J Lönroth, H Friberg, P Marcus, C |
| description | CONTEXT:
The prevalence of obesity among adolescents has increased and we lack effective treatments.
OBJECTIVE:
To determine if gastric bypass is safe and effective for an unselected cohort of adolescents with morbid obesity in specialized health care.
DESIGN, SETTING AND PATIENTS:
Intervention study for 81 adolescents (13–18 years) with a body mass index (BMI) range 36–69 kg m
−2
undergoing laparoscopic gastric bypass surgery in a university hospital setting in Sweden between April 2006 and May 2009. For weight change comparisons, we identified an adult group undergoing gastric bypass surgery (
n
=81) and an adolescent group (
n
=81) receiving conventional care.
MAIN OUTCOME MEASUREMENTS:
Two-year outcome regarding BMI in all groups, and metabolic risk factors and quality of life in the adolescent surgery group.
RESULTS:
Two-year follow-up rate was 100% in both surgery groups and 73% in the adolescent comparison group. In adolescents undergoing surgery, BMI was 45.5±6.1 (mean ±s.d.) at baseline and 30.2 (confidence interval 29.1–31.3) after 2 years (
P
20 mU l
−1
) was present in 70% of the adolescent surgery patients, which was reduced to 0% at 1 year and 3% at 2 years. Other cardiovascular risk factors were also improved. Two-thirds of adolescents undergoing surgery had a history of psychopathology. Nevertheless, the treatment was generally well tolerated and, overall, quality of life increased significantly. Adverse events were seen in 33% of patients.
CONCLUSIONS:
Adolescents with severe obesity demonstrated similar weight loss as adults following gastric bypass surgery yet demonstrating high prevalence of psychopathology at baseline. There were associated benefits for health and quality of life. Surgical and psychological challenges during follow-up require careful attention. |
| doi_str_mv | 10.1038/ijo.2012.160 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_534411</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A309980641</galeid><sourcerecordid>A309980641</sourcerecordid><originalsourceid>FETCH-LOGICAL-c695t-6917b206c082454037e836f2fe06e3319d5ff35611ac3180fc6064c19ba2ebbe3</originalsourceid><addsrcrecordid>eNqFkk1v1DAQhiMEglK4cUaWEKhIpIw_k3CrKr6kQiVaDpwsxxnvpmTjYCcs-x_40Tjt0hbEx2Fka_z4tWfmzbIHFPYp8PJ5e-b3GVC2TxXcyHaoKFQuRVXczHaAQ5GDVPJOdjfGMwCQEtjt7A7jAAXwYif7frr2-QZNIH4arV8h8Y50ZjDBR-uH1pIPfvqWY59_IgsTx5Ay9WYwMZK2J6bxHUaL_RjJuh2XJOJXDEmjxtiOmxckYJy6dOiCXxFDTtbYtHFJ3pux9f26bZCcjFOzIXsH745Pnt7LbjnTRby_XXezj69enh6-yY-OX789PDjKrarkmKuKFjUDZaFkQopUB5ZcOeYQFHJOq0Y6x6Wi1FhOS3BWgRKWVrVhWNfId7P8QjeucZhqPYR2ZcJGe9Pqbepz2qGWXAhKE3_0V76bhhR1ivmCYJxRYE6DUk6LUkpdmqbRWLrSUFYoLOg_n18kuZRanKtRJaAsE793wQ_Bf5kwjnrVpqZ3nenRT1FTJouCqzT5_6NU0ooJIWf00W_omZ9Cn_p-TnHBREWvqIXpULe982MwdhbVBxyqqkydnakn16glmm5cRt9N85Tjr-CzC9Amf8WA7rJ4Cnq2s0521rOdU_GQ8IfbP071CptL-Kd_E_B4C5hoTeeC6W0brzglSyjk9Zano36B4Vqxf3r4B3SvCZg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1151342491</pqid></control><display><type>article</type><title>Two-year outcome of laparoscopic Roux-en-Y gastric bypass in adolescents with severe obesity: results from a Swedish Nationwide Study (AMOS)</title><source>MEDLINE</source><source>SpringerLink Journals</source><source>Nature</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Olbers, T ; Gronowitz, E ; Werling, M ; Mårlid, S ; Flodmark, C-E ; Peltonen, M ; Göthberg, G ; Karlsson, J ; Ekbom, K ; Sjöström, L V ; Dahlgren, J ; Lönroth, H ; Friberg, P ; Marcus, C</creator><creatorcontrib>Olbers, T ; Gronowitz, E ; Werling, M ; Mårlid, S ; Flodmark, C-E ; Peltonen, M ; Göthberg, G ; Karlsson, J ; Ekbom, K ; Sjöström, L V ; Dahlgren, J ; Lönroth, H ; Friberg, P ; Marcus, C</creatorcontrib><description>CONTEXT:
The prevalence of obesity among adolescents has increased and we lack effective treatments.
OBJECTIVE:
To determine if gastric bypass is safe and effective for an unselected cohort of adolescents with morbid obesity in specialized health care.
DESIGN, SETTING AND PATIENTS:
Intervention study for 81 adolescents (13–18 years) with a body mass index (BMI) range 36–69 kg m
−2
undergoing laparoscopic gastric bypass surgery in a university hospital setting in Sweden between April 2006 and May 2009. For weight change comparisons, we identified an adult group undergoing gastric bypass surgery (
n
=81) and an adolescent group (
n
=81) receiving conventional care.
MAIN OUTCOME MEASUREMENTS:
Two-year outcome regarding BMI in all groups, and metabolic risk factors and quality of life in the adolescent surgery group.
RESULTS:
Two-year follow-up rate was 100% in both surgery groups and 73% in the adolescent comparison group. In adolescents undergoing surgery, BMI was 45.5±6.1 (mean ±s.d.) at baseline and 30.2 (confidence interval 29.1–31.3) after 2 years (
P
<0.001) corresponding to a 32% weight loss and a 76% loss of excess BMI. The 2-year weight loss was 31% in adult surgery patients, whereas 3% weight gain was seen in conventionally treated adolescents. At baseline, hyperinsulinemia (>20 mU l
−1
) was present in 70% of the adolescent surgery patients, which was reduced to 0% at 1 year and 3% at 2 years. Other cardiovascular risk factors were also improved. Two-thirds of adolescents undergoing surgery had a history of psychopathology. Nevertheless, the treatment was generally well tolerated and, overall, quality of life increased significantly. Adverse events were seen in 33% of patients.
CONCLUSIONS:
Adolescents with severe obesity demonstrated similar weight loss as adults following gastric bypass surgery yet demonstrating high prevalence of psychopathology at baseline. There were associated benefits for health and quality of life. Surgical and psychological challenges during follow-up require careful attention.</description><identifier>ISSN: 0307-0565</identifier><identifier>ISSN: 1476-5497</identifier><identifier>EISSN: 1476-5497</identifier><identifier>DOI: 10.1038/ijo.2012.160</identifier><identifier>PMID: 23007037</identifier><identifier>CODEN: IJOBDP</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>Adolescent ; Adolescents ; Adults ; Analysis ; bariatric ; bariatric-and-metabolic-surgery-original-article ; Biological and medical sciences ; Body Mass Index ; Care and treatment ; Cognition & reasoning ; Digestive system. Abdomen ; Endoscopy ; Epidemiology ; Female ; Follow-Up Studies ; Gastric bypass ; Gastric Bypass - methods ; Gastric Bypass - psychology ; Gastric Bypass - rehabilitation ; Gastroenterologi och hepatologi ; Gastroenterology and Hepatology ; Gastrointestinal surgery ; Health aspects ; Health care ; Health Promotion and Disease Prevention ; Health risks ; Health Sciences ; Heart surgery ; Hospitals ; Humans ; Hälsovetenskap ; Internal Medicine ; Investigative techniques, diagnostic techniques (general aspects) ; Laparoscopic surgery ; Laparoscopy ; Laparoscopy - methods ; Laparoscopy - psychology ; Laparoscopy - rehabilitation ; Male ; Medical and Health Sciences ; Medical sciences ; Medicin och hälsovetenskap ; Medicine ; Medicine & Public Health ; Metabolic Diseases ; Metabolism ; Miscellaneous ; Nutrition and Dietetics ; Näringslära ; Obesity ; Obesity in adolescence ; Obesity, Morbid - epidemiology ; Obesity, Morbid - psychology ; Obesity, Morbid - surgery ; Postoperative Complications - epidemiology ; Postoperative Complications - psychology ; Postoperative Complications - rehabilitation ; Prevalence ; Psychopathology ; Public Health ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Quality of Life ; Risk Factors ; Substance abuse treatment ; surgery ; Sweden - epidemiology ; Teenagers ; Treatment Outcome ; Weight control ; Weight Loss</subject><ispartof>INTERNATIONAL JOURNAL OF OBESITY, 2012-11, Vol.36 (11), p.1388-1395</ispartof><rights>Macmillan Publishers Limited 2012</rights><rights>2015 INIST-CNRS</rights><rights>COPYRIGHT 2012 Nature Publishing Group</rights><rights>Copyright Nature Publishing Group Nov 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c695t-6917b206c082454037e836f2fe06e3319d5ff35611ac3180fc6064c19ba2ebbe3</citedby><cites>FETCH-LOGICAL-c695t-6917b206c082454037e836f2fe06e3319d5ff35611ac3180fc6064c19ba2ebbe3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/ijo.2012.160$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/ijo.2012.160$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26580751$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23007037$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://gup.ub.gu.se/publication/164088$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttps://lup.lub.lu.se/record/3388361$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:125652055$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Olbers, T</creatorcontrib><creatorcontrib>Gronowitz, E</creatorcontrib><creatorcontrib>Werling, M</creatorcontrib><creatorcontrib>Mårlid, S</creatorcontrib><creatorcontrib>Flodmark, C-E</creatorcontrib><creatorcontrib>Peltonen, M</creatorcontrib><creatorcontrib>Göthberg, G</creatorcontrib><creatorcontrib>Karlsson, J</creatorcontrib><creatorcontrib>Ekbom, K</creatorcontrib><creatorcontrib>Sjöström, L V</creatorcontrib><creatorcontrib>Dahlgren, J</creatorcontrib><creatorcontrib>Lönroth, H</creatorcontrib><creatorcontrib>Friberg, P</creatorcontrib><creatorcontrib>Marcus, C</creatorcontrib><title>Two-year outcome of laparoscopic Roux-en-Y gastric bypass in adolescents with severe obesity: results from a Swedish Nationwide Study (AMOS)</title><title>INTERNATIONAL JOURNAL OF OBESITY</title><addtitle>Int J Obes</addtitle><addtitle>Int J Obes (Lond)</addtitle><description>CONTEXT:
The prevalence of obesity among adolescents has increased and we lack effective treatments.
OBJECTIVE:
To determine if gastric bypass is safe and effective for an unselected cohort of adolescents with morbid obesity in specialized health care.
DESIGN, SETTING AND PATIENTS:
Intervention study for 81 adolescents (13–18 years) with a body mass index (BMI) range 36–69 kg m
−2
undergoing laparoscopic gastric bypass surgery in a university hospital setting in Sweden between April 2006 and May 2009. For weight change comparisons, we identified an adult group undergoing gastric bypass surgery (
n
=81) and an adolescent group (
n
=81) receiving conventional care.
MAIN OUTCOME MEASUREMENTS:
Two-year outcome regarding BMI in all groups, and metabolic risk factors and quality of life in the adolescent surgery group.
RESULTS:
Two-year follow-up rate was 100% in both surgery groups and 73% in the adolescent comparison group. In adolescents undergoing surgery, BMI was 45.5±6.1 (mean ±s.d.) at baseline and 30.2 (confidence interval 29.1–31.3) after 2 years (
P
<0.001) corresponding to a 32% weight loss and a 76% loss of excess BMI. The 2-year weight loss was 31% in adult surgery patients, whereas 3% weight gain was seen in conventionally treated adolescents. At baseline, hyperinsulinemia (>20 mU l
−1
) was present in 70% of the adolescent surgery patients, which was reduced to 0% at 1 year and 3% at 2 years. Other cardiovascular risk factors were also improved. Two-thirds of adolescents undergoing surgery had a history of psychopathology. Nevertheless, the treatment was generally well tolerated and, overall, quality of life increased significantly. Adverse events were seen in 33% of patients.
CONCLUSIONS:
Adolescents with severe obesity demonstrated similar weight loss as adults following gastric bypass surgery yet demonstrating high prevalence of psychopathology at baseline. There were associated benefits for health and quality of life. Surgical and psychological challenges during follow-up require careful attention.</description><subject>Adolescent</subject><subject>Adolescents</subject><subject>Adults</subject><subject>Analysis</subject><subject>bariatric</subject><subject>bariatric-and-metabolic-surgery-original-article</subject><subject>Biological and medical sciences</subject><subject>Body Mass Index</subject><subject>Care and treatment</subject><subject>Cognition & reasoning</subject><subject>Digestive system. Abdomen</subject><subject>Endoscopy</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gastric bypass</subject><subject>Gastric Bypass - methods</subject><subject>Gastric Bypass - psychology</subject><subject>Gastric Bypass - rehabilitation</subject><subject>Gastroenterologi och hepatologi</subject><subject>Gastroenterology and Hepatology</subject><subject>Gastrointestinal surgery</subject><subject>Health aspects</subject><subject>Health care</subject><subject>Health Promotion and Disease Prevention</subject><subject>Health risks</subject><subject>Health Sciences</subject><subject>Heart surgery</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hälsovetenskap</subject><subject>Internal Medicine</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Laparoscopic surgery</subject><subject>Laparoscopy</subject><subject>Laparoscopy - methods</subject><subject>Laparoscopy - psychology</subject><subject>Laparoscopy - rehabilitation</subject><subject>Male</subject><subject>Medical and Health Sciences</subject><subject>Medical sciences</subject><subject>Medicin och hälsovetenskap</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metabolic Diseases</subject><subject>Metabolism</subject><subject>Miscellaneous</subject><subject>Nutrition and Dietetics</subject><subject>Näringslära</subject><subject>Obesity</subject><subject>Obesity in adolescence</subject><subject>Obesity, Morbid - epidemiology</subject><subject>Obesity, Morbid - psychology</subject><subject>Obesity, Morbid - surgery</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - psychology</subject><subject>Postoperative Complications - rehabilitation</subject><subject>Prevalence</subject><subject>Psychopathology</subject><subject>Public Health</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Quality of Life</subject><subject>Risk Factors</subject><subject>Substance abuse treatment</subject><subject>surgery</subject><subject>Sweden - epidemiology</subject><subject>Teenagers</subject><subject>Treatment Outcome</subject><subject>Weight control</subject><subject>Weight Loss</subject><issn>0307-0565</issn><issn>1476-5497</issn><issn>1476-5497</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkk1v1DAQhiMEglK4cUaWEKhIpIw_k3CrKr6kQiVaDpwsxxnvpmTjYCcs-x_40Tjt0hbEx2Fka_z4tWfmzbIHFPYp8PJ5e-b3GVC2TxXcyHaoKFQuRVXczHaAQ5GDVPJOdjfGMwCQEtjt7A7jAAXwYif7frr2-QZNIH4arV8h8Y50ZjDBR-uH1pIPfvqWY59_IgsTx5Ay9WYwMZK2J6bxHUaL_RjJuh2XJOJXDEmjxtiOmxckYJy6dOiCXxFDTtbYtHFJ3pux9f26bZCcjFOzIXsH745Pnt7LbjnTRby_XXezj69enh6-yY-OX789PDjKrarkmKuKFjUDZaFkQopUB5ZcOeYQFHJOq0Y6x6Wi1FhOS3BWgRKWVrVhWNfId7P8QjeucZhqPYR2ZcJGe9Pqbepz2qGWXAhKE3_0V76bhhR1ivmCYJxRYE6DUk6LUkpdmqbRWLrSUFYoLOg_n18kuZRanKtRJaAsE793wQ_Bf5kwjnrVpqZ3nenRT1FTJouCqzT5_6NU0ooJIWf00W_omZ9Cn_p-TnHBREWvqIXpULe982MwdhbVBxyqqkydnakn16glmm5cRt9N85Tjr-CzC9Amf8WA7rJ4Cnq2s0521rOdU_GQ8IfbP071CptL-Kd_E_B4C5hoTeeC6W0brzglSyjk9Zano36B4Vqxf3r4B3SvCZg</recordid><startdate>20121101</startdate><enddate>20121101</enddate><creator>Olbers, T</creator><creator>Gronowitz, E</creator><creator>Werling, M</creator><creator>Mårlid, S</creator><creator>Flodmark, C-E</creator><creator>Peltonen, M</creator><creator>Göthberg, G</creator><creator>Karlsson, J</creator><creator>Ekbom, K</creator><creator>Sjöström, L V</creator><creator>Dahlgren, J</creator><creator>Lönroth, H</creator><creator>Friberg, P</creator><creator>Marcus, C</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T2</scope><scope>7TK</scope><scope>7TS</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>7U1</scope><scope>7U2</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>F1U</scope><scope>D95</scope></search><sort><creationdate>20121101</creationdate><title>Two-year outcome of laparoscopic Roux-en-Y gastric bypass in adolescents with severe obesity: results from a Swedish Nationwide Study (AMOS)</title><author>Olbers, T ; Gronowitz, E ; Werling, M ; Mårlid, S ; Flodmark, C-E ; Peltonen, M ; Göthberg, G ; Karlsson, J ; Ekbom, K ; Sjöström, L V ; Dahlgren, J ; Lönroth, H ; Friberg, P ; Marcus, C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c695t-6917b206c082454037e836f2fe06e3319d5ff35611ac3180fc6064c19ba2ebbe3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adolescent</topic><topic>Adolescents</topic><topic>Adults</topic><topic>Analysis</topic><topic>bariatric</topic><topic>bariatric-and-metabolic-surgery-original-article</topic><topic>Biological and medical sciences</topic><topic>Body Mass Index</topic><topic>Care and treatment</topic><topic>Cognition & reasoning</topic><topic>Digestive system. Abdomen</topic><topic>Endoscopy</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gastric bypass</topic><topic>Gastric Bypass - methods</topic><topic>Gastric Bypass - psychology</topic><topic>Gastric Bypass - rehabilitation</topic><topic>Gastroenterologi och hepatologi</topic><topic>Gastroenterology and Hepatology</topic><topic>Gastrointestinal surgery</topic><topic>Health aspects</topic><topic>Health care</topic><topic>Health Promotion and Disease Prevention</topic><topic>Health risks</topic><topic>Health Sciences</topic><topic>Heart surgery</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Hälsovetenskap</topic><topic>Internal Medicine</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Laparoscopic surgery</topic><topic>Laparoscopy</topic><topic>Laparoscopy - methods</topic><topic>Laparoscopy - psychology</topic><topic>Laparoscopy - rehabilitation</topic><topic>Male</topic><topic>Medical and Health Sciences</topic><topic>Medical sciences</topic><topic>Medicin och hälsovetenskap</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metabolic Diseases</topic><topic>Metabolism</topic><topic>Miscellaneous</topic><topic>Nutrition and Dietetics</topic><topic>Näringslära</topic><topic>Obesity</topic><topic>Obesity in adolescence</topic><topic>Obesity, Morbid - epidemiology</topic><topic>Obesity, Morbid - psychology</topic><topic>Obesity, Morbid - surgery</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - psychology</topic><topic>Postoperative Complications - rehabilitation</topic><topic>Prevalence</topic><topic>Psychopathology</topic><topic>Public Health</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Quality of Life</topic><topic>Risk Factors</topic><topic>Substance abuse treatment</topic><topic>surgery</topic><topic>Sweden - epidemiology</topic><topic>Teenagers</topic><topic>Treatment Outcome</topic><topic>Weight control</topic><topic>Weight Loss</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Olbers, T</creatorcontrib><creatorcontrib>Gronowitz, E</creatorcontrib><creatorcontrib>Werling, M</creatorcontrib><creatorcontrib>Mårlid, S</creatorcontrib><creatorcontrib>Flodmark, C-E</creatorcontrib><creatorcontrib>Peltonen, M</creatorcontrib><creatorcontrib>Göthberg, G</creatorcontrib><creatorcontrib>Karlsson, J</creatorcontrib><creatorcontrib>Ekbom, K</creatorcontrib><creatorcontrib>Sjöström, L V</creatorcontrib><creatorcontrib>Dahlgren, J</creatorcontrib><creatorcontrib>Lönroth, H</creatorcontrib><creatorcontrib>Friberg, P</creatorcontrib><creatorcontrib>Marcus, C</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Neurosciences Abstracts</collection><collection>Physical Education Index</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Göteborgs universitet</collection><collection>SWEPUB Lunds universitet</collection><jtitle>INTERNATIONAL JOURNAL OF OBESITY</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Olbers, T</au><au>Gronowitz, E</au><au>Werling, M</au><au>Mårlid, S</au><au>Flodmark, C-E</au><au>Peltonen, M</au><au>Göthberg, G</au><au>Karlsson, J</au><au>Ekbom, K</au><au>Sjöström, L V</au><au>Dahlgren, J</au><au>Lönroth, H</au><au>Friberg, P</au><au>Marcus, C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Two-year outcome of laparoscopic Roux-en-Y gastric bypass in adolescents with severe obesity: results from a Swedish Nationwide Study (AMOS)</atitle><jtitle>INTERNATIONAL JOURNAL OF OBESITY</jtitle><stitle>Int J Obes</stitle><addtitle>Int J Obes (Lond)</addtitle><date>2012-11-01</date><risdate>2012</risdate><volume>36</volume><issue>11</issue><spage>1388</spage><epage>1395</epage><pages>1388-1395</pages><issn>0307-0565</issn><issn>1476-5497</issn><eissn>1476-5497</eissn><coden>IJOBDP</coden><abstract>CONTEXT:
The prevalence of obesity among adolescents has increased and we lack effective treatments.
OBJECTIVE:
To determine if gastric bypass is safe and effective for an unselected cohort of adolescents with morbid obesity in specialized health care.
DESIGN, SETTING AND PATIENTS:
Intervention study for 81 adolescents (13–18 years) with a body mass index (BMI) range 36–69 kg m
−2
undergoing laparoscopic gastric bypass surgery in a university hospital setting in Sweden between April 2006 and May 2009. For weight change comparisons, we identified an adult group undergoing gastric bypass surgery (
n
=81) and an adolescent group (
n
=81) receiving conventional care.
MAIN OUTCOME MEASUREMENTS:
Two-year outcome regarding BMI in all groups, and metabolic risk factors and quality of life in the adolescent surgery group.
RESULTS:
Two-year follow-up rate was 100% in both surgery groups and 73% in the adolescent comparison group. In adolescents undergoing surgery, BMI was 45.5±6.1 (mean ±s.d.) at baseline and 30.2 (confidence interval 29.1–31.3) after 2 years (
P
<0.001) corresponding to a 32% weight loss and a 76% loss of excess BMI. The 2-year weight loss was 31% in adult surgery patients, whereas 3% weight gain was seen in conventionally treated adolescents. At baseline, hyperinsulinemia (>20 mU l
−1
) was present in 70% of the adolescent surgery patients, which was reduced to 0% at 1 year and 3% at 2 years. Other cardiovascular risk factors were also improved. Two-thirds of adolescents undergoing surgery had a history of psychopathology. Nevertheless, the treatment was generally well tolerated and, overall, quality of life increased significantly. Adverse events were seen in 33% of patients.
CONCLUSIONS:
Adolescents with severe obesity demonstrated similar weight loss as adults following gastric bypass surgery yet demonstrating high prevalence of psychopathology at baseline. There were associated benefits for health and quality of life. Surgical and psychological challenges during follow-up require careful attention.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>23007037</pmid><doi>10.1038/ijo.2012.160</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0307-0565 |
| ispartof | INTERNATIONAL JOURNAL OF OBESITY, 2012-11, Vol.36 (11), p.1388-1395 |
| issn | 0307-0565 1476-5497 1476-5497 |
| language | eng |
| recordid | cdi_swepub_primary_oai_swepub_ki_se_534411 |
| source | MEDLINE; SpringerLink Journals; Nature; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Adolescent Adolescents Adults Analysis bariatric bariatric-and-metabolic-surgery-original-article Biological and medical sciences Body Mass Index Care and treatment Cognition & reasoning Digestive system. Abdomen Endoscopy Epidemiology Female Follow-Up Studies Gastric bypass Gastric Bypass - methods Gastric Bypass - psychology Gastric Bypass - rehabilitation Gastroenterologi och hepatologi Gastroenterology and Hepatology Gastrointestinal surgery Health aspects Health care Health Promotion and Disease Prevention Health risks Health Sciences Heart surgery Hospitals Humans Hälsovetenskap Internal Medicine Investigative techniques, diagnostic techniques (general aspects) Laparoscopic surgery Laparoscopy Laparoscopy - methods Laparoscopy - psychology Laparoscopy - rehabilitation Male Medical and Health Sciences Medical sciences Medicin och hälsovetenskap Medicine Medicine & Public Health Metabolic Diseases Metabolism Miscellaneous Nutrition and Dietetics Näringslära Obesity Obesity in adolescence Obesity, Morbid - epidemiology Obesity, Morbid - psychology Obesity, Morbid - surgery Postoperative Complications - epidemiology Postoperative Complications - psychology Postoperative Complications - rehabilitation Prevalence Psychopathology Public Health Public health. Hygiene Public health. Hygiene-occupational medicine Quality of Life Risk Factors Substance abuse treatment surgery Sweden - epidemiology Teenagers Treatment Outcome Weight control Weight Loss |
| title | Two-year outcome of laparoscopic Roux-en-Y gastric bypass in adolescents with severe obesity: results from a Swedish Nationwide Study (AMOS) |
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