A 5-Year Follow-Up Study of Laparoscopic Sleeve Gastrectomy Among Morbidly Obese Adolescents: Does It Improve Body Image and Prevent and Treat Diabetes?

Background: Laparoscopic sleeve gastrectomy (LSG) is widely used, and it is important to examine its physiologic and psychological efficacy among adolescents. We assessed LSG’s efficacy for weight loss, its short- and long-term effects on resolving and improving obesity-related comorbidities, and its psychological outcomes among morbidly obese adolescents. Methods: We retrospectively analyzed the medical records of 91 morbidly obese adolescents in Qatar who underwent LSG (2011–2014), with 1- and 5-year follow-ups. Results: The mean preoperative weight and body mass index (BMI) were 132.5 ± 25.3 kg and 48 ± 7.5 kg/m², respectively. Postoperatively, mean weight and BMI decreased to 101 ± 22 kg and 36.4 ± 7.2 kg/m², respectively. At 1 year, the mean excess weight loss (%EWL), percent total weight loss (%TWL), and percent BMI loss (%BMIL) were 49.48 ± 25.8, 23.1 ± 11.9, and 23.16 ± 11.8%, respectively. At 5 years, %EWL, %TWL, and %BML were 78 ± 12, 35.8 ± 11.5, and 36 ± 12%, respectively. No patients developed postoperative leaks, and three patients had endoscopic dilatation due to stenosis. Overall, 64% of obstructive sleep apnea patients were cured, all prediabetic patients had total remission, and 50% of the diabetic patients were cured. The overall mean HBA1c level was 6 mmol/L, which significantly decreased to 5.1 mmol/L postoperatively (P = 0.0001). At 5 years, there was no relapse of diabetes, and 75% of the diabetic adolescents had complete remission. The only patient with hypertension showed complete resolution with laparoscopic sleeve gastrectomy. Postoperatively, overall body image satisfaction significantly improved (P = 0.0001). Conclusion: LSG significantly ameliorated short- and long-term obesity-related comorbidities and body image dissatisfaction among Qatari adolescents.