An increasing number of American children and teens are resorting to weight-loss surgeries to combat severe obesity. However, a recent study has revealed that these surgeries may have detrimental effects on their bone density and strength at a time when young people should be focusing on building optimal bone mass.
Young adults and teenagers who had the surgery and experienced substantial weight loss displayed weaker bone structure compared to their counterparts who had similar levels of obesity but did not undergo surgery, according to the results.
“We found that bone strength was lower two years after weight-loss surgery, while bone marrow fat, a marker of bone weakening, was increased, suggesting that weight-loss surgery has negative effects on bone health,” the study’s lead investigator, Miriam Bredella, professor of radiology at Harvard Medical School, said in a press release.
Sleeve gastrectomy has emerged as one of the most common forms of weight-loss surgery. The procedure involves the removal of approximately 75 to 85 percent of the stomach. Consequently, the amount of food the body can consume and absorb is restricted, leading to long-term weight loss.
Why Bone Health Is Crucial in Young AdultsThe surgery’s effect on bone health is “clinically important,” according to Dr. Thomas Link, a professor of radiology, and Dr. Anne Schafer, a professor of medicine, epidemiology, and biostatistics, both at the University of California in San Francisco, who wrote a review of the study. "Adolescence is a time for building up bone mass, which will serve as a reservoir for one’s entire adult life before it steadily declines in the later stages of adulthood.”
Why the Increase in Weight-Loss Surgeries Is ConcerningThe American Academy of Pediatrics issued a policy statement in 2019 emphasizing the importance of enhancing access to metabolic and bariatric surgery for adolescents when medically necessary. There was a notable rise in the total number of completed youth bariatric surgeries—from 1,135 in 2020 to 1,349 in 2021, representing a nearly 19 percent increase.
The statement, believed to have influenced the increase in bariatric surgeries among young individuals, has sparked concerns regarding its potential impact, especially on younger children, considered a vulnerable population. Some doctors are hesitant to recommend bariatric surgeries for this group, highlighting that they are irreversible, invasive procedures with potentially lifelong consequences, and the availability of long-term data is limited.
Study LimitationsThe study authors acknowledged certain limitations of their research.
Firstly, the participants were not randomly assigned, and it was observed that individuals in the surgical group had higher BMIs.
Secondly, although the study aimed to examine the long-term risk of bone fractures, the follow-up period was limited to 24 months.