May 5, 2024

Weight-Loss Surgery’s Hidden Hazard: Weakened Bones in Teens and Young Adults

Sleeve gastrectomy gets rid of roughly 75% to 80% of the stomach to limit food consumption and cause weight-loss. It leads to an usually round stomach handling the shape of a tube or sleeve. The estimated number of sleeve gastrectomy procedures performed each year increased from over 28,000 surgeries in 2011 to over 122,000 in 2020, according to the American Society for Metabolic and Bariatric Surgery. Sleeve gastrectomy has actually surpassed stomach bypass as the main weight-loss operation.
For the research study, participants in between the age of 13 and 24 years were registered from 2015 to 2020. The teenagers and young people had moderate to severe obesity. The young people had a body max index (BMI) of 35 or above. A BMI of 30 or above is thought about overweight. Teen individuals were at 120% of the 95th age- and sex-specific percentile.
There were 54 participants, 25 who went through sleeve gastrectomy and 29 who remained in the control group. Forty-one research study individuals were female. The surgical group included participants with at least one obesity-related co-morbidity, or a BMI at or above 40. The control group had weight problems however did not plan to undergo sleeve gastrectomy but got dietary and exercise therapy.
Biomechanical noncontrast CT analysis of the L1 vertebra in an 18-year-old female with serious weight problems (body mass index [BMI], 48.4 kg/m2) prior to sleeve gastrectomy (SG) and 24 months after surgery (BMI, 26.6 kg/m2). L1 vertebra was packed to 9820 N at both check outs for contrast functions. Breaking strength was (A) 11 920 N at standard prior to SG and (B) 9820 N at 24 months after surgery. Cutout views of the limited element designs under compressive load portray the distribution of bone mineral density (black and white locations) and bone failure (colored locations). Red suggests tissue that failed earlier during the compressive load (weaker bone). Shades of gray suggest various bone densities, with white being dense bone and black being little or no bone mineral. Credit: Radiological Society of North America
Before and 24 months after sleeve gastrectomy, individuals underwent a physical assessment, blood tests and quantitative CT of the lumbar spine, to measure volumetric bone mineral density and to carry out limited component analysis, a technique that can estimate bone strength. Quantitative CT is an extremely precise strategy for detecting changes in volumetric bone mineral density after severe weight loss.
Studies have actually shown that bone marrow fat responds to modifications in nutrition and might act as a biomarker for bone quality. Clients underwent proton MR spectroscopy to measure bone marrow fat of the back spinal column.
Two years following surgery, BMI in the adolescents and young grownups dropped (-11.9, usually), while there was a slight rise in BMI in the control group (+1.5, typically). Compared to the controls, sleeve gastrectomy clients had a significant increase in bone marrow fat and a decline in bone density and strength quotes in the back spinal column.
” We discovered that bone strength was lower 2 years after weight-loss surgery, while bone marrow fat, a marker of bone weakening, was increased, recommending that weight-loss surgery has negative results on bone health,” Dr. Bredella said.
Dr. Bredella mentions that the teen years are a vital time for building up bone mass, and deficits in bone accrual throughout these years might have a long-term effect on bone health and fracture risk in this more youthful population later in life.
” As bariatric surgical treatment is progressively performed in adolescents, its impact on bone health requires to be stressed, specifically to the doctors who will continue to supply routine treatment for these clients,” Dr. Bredella said. “We hope that our study will raise awareness on the effects of weight-loss surgery on bones in teenagers with weight problems.”
Raising awareness of the importance of bone health will enable monitoring and management of low bone mass, optimal dietary supplements with vitamin D and calcium, and the initiation of appropriate therapy, if needed, Dr. Bredella noted.
” Our observed impacts of weight-loss surgery on bone strength and bone marrow fat may also determine brand-new targets for novel therapies,” she stated.
Recommendation: “Two-year Skeletal Effects of Sleeve Gastrectomy in Adolescents with Obesity Assesses with Quantitative CT and MR Spectroscopy” by Florian A. Huber, Vibha Singhal, Shubhangi Tuli, Imen Becetti, Ana Paola López López, Mary L. Bouxsein, Madhusmita Misra and Miriam A. Bredella, 13 June 2023, Radiology.DOI: 10.1148/ radiol.223256.
Teaming Up with Dr. Bredella were Florian A. Huber, M.D., Vibha Singhal, M.D., M.P.H., Shubhangi Tuli, M.B.B.S., Imen Becetti, M.D., Ana Paola López López, M.D., Mary L. Bouxsein, Ph.D., and Madhusmita Misra, M.D., M.P.H.

Research study has discovered that a popular weight-loss surgical treatment, sleeve gastrectomy, adversely impacts bone health in adolescents and young adults. 2 years after surgery, although clients BMI considerably dropped, bone marrow fat increased, and bone density and strength reduced. The research highlights the need for monitoring and managing bone health post-surgery, potentially notifying novel therapies.
Cutout views of the limited aspect models under compressive load portray the circulation of bone mineral density (white and black areas) and bone failure (colored locations). Tones of gray indicate various bone densities, with white being thick bone and black being little or no bone mineral.

A study released in Radiology exposed hazardous effects on bones from a widespread weight-loss surgical treatment, sleeve gastrectomy, for young adults and overweight teenagers.
Research study has actually found that a popular weight-loss surgery, sleeve gastrectomy, adversely effects bone health in teenagers and young people. 2 years after surgery, although patients BMI considerably dropped, bone marrow fat increased, and bone density and strength minimized. The research highlights the need for tracking and managing bone health post-surgery, potentially informing unique treatments.
A common weight-loss surgery for overweight teenagers and young people is discovered to have harmful effects on bones, according to a research study published in Radiology, a journal of the Radiological Society of North America (RSNA).
” Childhood obesity is on the rise and weight-loss surgery is the most effective way to decrease weight and improve cardiometabolic comorbidities,” stated the research studys lead detective, Miriam A. Bredella, M.D., professor of radiology at Harvard Medical School in Boston, Massachusetts, and vice chair for Faculty Affairs and Clinical Operations, Department of Radiology Massachusetts General Hospital in Boston. “This is the first research study in adolescents and young people that examined the long-term effects of sleeve gastrectomy, the most common type of weight-loss surgical treatment, on bone strength and bone marrow fat.”