Reducing Cardiovascular Risk Factors in Patients Who Are Obese: Identifying Those Whom Bariatric Surgery Can Help :

We, along with other journals, have published a number of studies discussing outcome results in older children and adolescents who undergo bariatric surgery. Often these patients present with cardiovascular disease risk factors as a reason for undergoing the surgery. While it is known that bariatric surgery can reduce the severity of these risk factors, we don’t know if that goes for all patients or a subset of patients who are more apt to show better cardiovascular metrics post-op than others—at least until Michalsky et al. (10.1542/peds.2017-2485) analyzed data for a longitudinal data base of teenagers undergoing bariatric surgery.  The authors looked at 242 teenagers who underwent bariatric surgery and tried to identify predictors for greatest improvement in metrics such as blood pressure, lipids, glucose homeostasis, and inflammation for three-years post-op.  The authors found that while this surgery did benefit essentially all patients from a cardiovascular standpoint, those who were female, younger, and showed increased weight loss had the greatest reductions in cardiovascular disease risk factors.  While just reading the results of the teens who got this surgery is more than enough to digest, this study also makes us think about whether some of the variables identified in this study should be more emphasized in deciding who should go forward with this surgery and at what age to optimize outcomes, not just in terms of weight loss but from a cardiovascular standpoint as well. Take heart and check out this study which may help you in your working with a patient who is obese to determine if and when bariatric surgery makes sense.