In a study of morbidly obese children, cardiac risk
factors improved within six months of bariatric surgery.
"Importantly, these improvements persisted for at least two years following
profound weight loss," says Holly M.
Ippisch, MD, assistant professor of pediatrics at Cincinnati Children’s
Hospital Medical Center.
By reversing heart abnormalities early in
life, "we can reduce their risk of heart disease as adults," she
The study, presented at the annual meeting of the American Heart
Association, involved 83 morbidly obese teens, 21 of whom have been followed
for two years.
Among the findings:
The average body mass index (BMI) of the
teens dropped from 58 before surgery to 38 two years later. Normal BMI is 18.5
to 24.9. "One boy, who was 356 pounds at the outset, lost over 100
pounds," Ippisch says.
The percentage of youths with structural heart abnormalities decreased from
49% before surgery to 24% after two years.
The ability of the heart to relax improved within six months and persisted
for two years. "When the heart doesn't relax as it should, that's a sign of
heart stiffness, an early precursor to heart failure," Ippisch
At the start of the study, all the teens suffered from enlarged heart
muscle. The heart works harder yet accomplishes less pumping. By six months, it
improved and remained improved for two years, she says.
Many teens are also much happier after the surgery, she says. "They say, I
can get in a car and fasten the seatbelt now, I can go on a roller coaster --
all the things teens are supposed to do," Ippisch says.
Weight Loss Surgery: Who Should Get It and Who Shouldn't
Not all adolescents who are overweight should consider bariatric surgery as
a way to improve their heart health, doctors warn.
Teens who are candidates for bariatric surgery include those who are
morbidly obese, which for most people means being 100 or more pounds overweight
or having a BMI of 40 or more as well as having a serious health condition such
as diabetes, according to Stephen Daniels, MD, PhD, chairman
of pediatrics at the University of Colorado in Denver.
"Teens with a body mass index of 50 or more may be candidates even if they
don't have other health conditions because at that level of obesity, they often
have trouble with activities of daily living," says Daniels, who moderated a
news conference on childhood obesity.
Obesity Epidemic in Children Continues
Also at the meeting, researchers reported that kids today are fatter than
kids a decade ago, which increases the chances they'll develop heart disease as
David Crowley, MD, of Cincinnati Children's Hospital Medical Center, and
colleagues studied 700 healthy children and teens: half visited their clinic
between 1986 and 1988 and half were seen in 2008.
"Children today [the 2008 group] weighed an average of 11 pounds more than
kids 10 years ago," he says. They were also three times more likely to be
The average BMI was also significantly higher in the 2008 group: 19.9 vs.
18.1 for the 1986-1988 group.
Boys and African-Americans were at particularly heightened risk for obesity,
the study showed.
"If we don't get a handle on this obesity epidemic, these children will be
at risk of heart attack and stroke in middle age," Crowley