Obese teens are increasingly resorting to surgery to achieve the weight loss results they need. A team of researchers from the University of Cincinnati collaborated with local hospitals to study how weight loss surgery affected heart health in a small group of obese teen boys. The findings, presented at the American Heart Association’s 2016 Scientific Sessions, reveal how undergoing surgery during teenage years may be the trick to preventing heart damage as adults.

"We already knew that weight loss surgery improves weight and cholesterol numbers," said the study’s lead author pediatric endocrinologist Amy S. Shah, professor of pediatrics at the Cincinnati Children's Hospital, in a statement. “This new research shows that there are actually changes in the way HDL functions in adolescents, which may lead to a reduction in long-term cardiovascular risk.”

For the study, researchers recruited 10 severely obese teenage boys who weighed in at an average of 367 pounds. Most of them were about 17 years old and Caucasian. Each teen underwent a vertical sleeve gastrectomy, which is a type of operation that reduces the size of the stomach by surgically cutting and removing part of the stomach and leaving a tube shape for food to pass through. It leads the person to feel fuller, sooner and ultimately eat less and be less hungry.

After the surgery, researchers checked in a year later to see how the teens were doing. They lost an average weight of 111 pounds and were able to reduce their body mass index (BMI) by 32 percent. BMI is a way to measure body fat based on your weight to height ratio, which is a quantifiable way of reflecting a person’s health from underweight, normal, overweight, up to obese.

But researchers also found the participants’ levels of high density lipoprotein (HDL), also known as good cholesterol, rose tremendously. On average, the teens experienced a 23 percent increase in their HDL levels, which helps remove the hard, thick plaque buildup that can potentially clog the arteries; oftentimes the catalyst to a heart attack or stroke.

“How the good cholesterol functions in the body is important,” Shah explained to Medical Daily.  “HDL gets its name as the good cholesterol because it has the ability to remove cholesterol from artery walls. If HDL is more efficient at doing its job then it has the potential to reduce cardiovascular risk.”

Because obesity is so intertwined with the risk factors for heart disease, the participants could have developed serious heart conditions. According to the National Heart, Lung, and Blood Institute, as your BMI rises, so does your risk for coronary heart disease.

“Cardiovascular disease begins in childhood,” Shah said. “In addition, cardiovascular risk factors track from childhood to adulthood, therefore early intervention is key for reducing heart disease.”

Weighing the Benefits of Surgery

For their next step, Shah and her team will look at the effect of weight loss surgery on obese teen girls and how the operation affects their BMI and HDL levels. Although the researchers have found heart-healthy benefits from undergoing the surgery, the life-changing operation is for those who already have tried nearly everything to lose weight and stay healthy.

It’s only after the teen has tried and failed at diets and exercises designed to lower their weight that weight loss surgery turns into the most viable option to keep the teen healthy. When considering weight loss surgery, parents, teens, and the surgical team work through an extensive process to make sure the treatment is right for them, according to the Children’s Cincinnati Hospital Medical Center.

Teens have to reach physical maturity, meaning they are no longer prepubescent and have experienced most of their major hormonal fluctuations. Not only do they have to be physically ready, but also emotionally and mentally mature. They cannot have an untreated eating disorder or mental illness, and must go through counseling afterwards to learn how to eat with portion control.

In the end, as many as 50 percent of patients who undergo the surgery will regain some weight two or more years later, however most maintain successful, long-term weight loss, according to the American Society for Metabolic and Bariatric Surgery. A 2015 study confirmed that teens reap the same benefits and are also able to keep the weight off years after the procedure despite their bodies still going through development. In addition to lowering the risk of heart disease, teens were also able to reduce the potential for many other obesity-related diseases, like diabetes.  

Source: Shah AM, Inge T, Sexmith H, Heink A, Davidson WS. Effects of Vertical Sleeve Gastrectomy on HDL Function in Adolescents with Severe Obesity. American Heart Association’s 2016 Scientific Sessions . 2016.