Bariatric Surgery in Adolescents With Obesity: Weight and Cardiometabolic Outcomes—Real-World Data

Abstract

Objective: This study evaluated changes in weight status and cardiometabolic parameters following bariatric surgery (BS) among adolescents with obesity using population-based real-world data. Methods: This retrospective cohort study used electronic health records from Clalit Health Services, Israel. Adolescents aged 12–20 years who underwent BS between 2010 and 2024 were included. Demographic characteristics, socioeconomic position (SEP), anthropometry, blood pressure, and laboratory parameters were extracted. Longitudinal changes in BMI and cardiometabolic outcomes were analyzed using mixed-effects models adjusted for sex, ethnicity, SEP, age at BS, and baseline BMI. Median follow-up was 5.8 years. Results: The cohort included 1035 adolescents (69.7% female; median age at surgery ~18.6 years), with sleeve gastrectomy as the predominant procedure. BMI declined significantly over time (ptime < 0.001), with maximal reduction at 1–3 years and sustained improvement thereafter. Males experienced greater BMI reduction than females (ptime×sex < 0.001). BMI trajectories were similar across SEP and ethnic groups, while individuals with higher baseline BMI maintained higher BMI throughout follow-up (pgroup < 0.001). Blood pressure and multiple metabolic parameters improved substantially, with durable long-term benefits and some sex-specific differences. Conclusions: Adolescent BS was associated with sustained improvements in BMI and cardiometabolic risk factors in a large real-world cohort, supporting its long-term effectiveness across population subgroups.