Weight Loss Surgery Helps Teen's Hearts

Study Shows Bariatric Surgery Reduces Risk for Heart Attack, Stroke in Teens

By Charlene Laino
WebMD Health News

Reviewed By Louise Chang, MD

Nov. 17, 2009 (Orlando, Fla.) -- Weight loss surgery quickly improves the heart health of obese teens and continues to do so for at least two years, researchers report.

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 tells WebMD.

Weight Loss Surgery and Heart Health

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.
• Heart rate and blood pressure improved.
• 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 says.
• 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 adults.

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 obese.

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 says.

SOURCES: American Heart Association Scientific Sessions 2009, Orlando, Fla., Nov. 15-19, 2009.

Holly M. Ippisch, MD, assistant professor of pediatrics, Cincinnati Children's Hospital Medical Center.

Stephen Daniels, MD, PhD, chairman of pediatrics, University of Colorado, Denver.

David Crowley, MD, Cincinnati Children's Hospital Medical Center.

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