High prevalence of attention-deficit/hyperactivity disorder in adolescents with severe obesity seeking bariatric surgery.

AIM: To examine the prevalence of attention-deficit/hyperactivity disorder (ADHD) and related post-surgical weight loss in adolescents with severe obesity seeking bariatric surgery. METHODS: The study population included 84 adolescents (age 13-19 years; 44 males, 40 females) with severe obesity who sought bariatric surgery at the Sheba Medical Centre in Israel during the years 2011-2017. Anthropometric and clinical data were collected from medical records. A subgroup of 20 participants filled questionnaires that evaluated ADHD-like symptoms, eating behaviours and quality of life. Data on adolescents that ultimately underwent surgery (n = 45) were also obtained. RESULTS: The prevalence of ADHD was 28.6% in adolescents seeking bariatric surgery, much higher than that of the general adolescent population of Israel (17.1%, P < .001). There were no significant differences in reductions of weight, body mass index, body mass index standard deviation scores and body fat percent between participants with or without ADHD. In the subgroup that filled questionnaires, higher scores on ADHD-Rating Scale at baseline were associated with greater excess weight loss. CONCLUSION: The prevalence of ADHD in adolescents seeking bariatric surgery was very high. Diagnosed ADHD was not related to post-surgical weight loss, whereas baseline ADHD-related behaviour was associated with higher post-surgical weight loss.

Body composition changes in adolescents after laparoscopic sleeve gastrectomy.

BACKGROUND: Sleeve gastrectomy (SG) is a commonly used bariatric procedure in severely obese adolescents. Weight loss after SG is associated with marked changes in body composition, but factors associated with such changes have not yet been described in adolescents. OBJECTIVE: To identify factors associated with changes in body weight and composition in adolescents 1 year after SG. SETTING: University Hospital, Tel Hashomer, Israel. METHODS: Age, sex, weight, height, preoperative body mass index (BMI), and body fat percent measured by bioimpedance were collected in 25 adolescents (16 males, 9 females, age 16.6±1.5 yr) before and 1 year after SG. Obesity-related complications, preoperative weight loss, and physical activity after surgery were also recorded. Repeated-measures analyses of variance and linear mixed model analyses were performed. RESULTS: One year after SG, weight decreased by 32%, fat mass by 55%, and fat-free mass by 9% from baseline. Male participants lost significantly more weight than female participants, with larger decreases in fat mass (-65% versus -41%, P<.001) and body fat percent (-48% versus -21%, P<.001). The amount of physical activity at 1-year follow-up was also associated with larger reductions in body fat percent in both genders. Age or baseline BMI, fat mass, and fat-free mass were not associated with changes in BMI or body composition. CONCLUSION: Among obese adolescents 1 year after SG, the only modifiable factor associated with larger decreases in body fat percent was physical activity. Larger studies are needed to formally identify other possible predictors of body composition changes after SG.