Study: bariatric surgery effective for pediatric weight loss, but may adversely affect bone health

Editor's Note

What researchers say is the first systematic review and meta-analysis to report on bone health outcomes from pediatric bariatric surgery shows the procedure is highly effective at achieving weight loss amid a childhood obesity crisis of epidemic proportions. However, the surgery also could put patients at greater risk of fracture and/or osteomalacia. Writing February 1 in eClininical Medicine, part of The Lancet – Discovery Science, the authors say the study highlights the need for further review of bone health and pediatric bariatric surgery “as a matter of urgency.”

Their review examined 12 studies with 681 patients from 5 countries who underwent Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy, gastric band, or intragastric balloon placement. Generally, bariatric surgery is effective in achieving significant reductions in weight and body mass index, with RYGB being most effective. However, patients who underwent SG or RYGB—the most common BS interventions among primarily adolescent patient populations in North America—had significantly lower lumbar bone mineral density and subtotal body bone mineral density. They also showed higher markers of bone resorption, reduced calcium levels, and other indications of deteriorated bone health.

“It is crucial to monitor and support bone health through appropriate nutritional supplementation and judicious follow-up,” researchers conclude. “Long-term data is needed to fully understand the clinical implications of these findings on bone outcomes.”