Weight loss after sleeve gastrectomy in developmentally delayed adolescents and young adults

Background Adolescent obesity is a significant factor in caring for patients with developmental delay (DD). Sleeve gastrectomy provides durable weight loss for teens with obesity but requires behavioral change that may not occur in patients with DD. Objectives To determine whether patients with DD had similar weight loss and adverse outcomes to patients without a diagnosis of DD after sleeve gastrectomy. Setting Academic children's hospital, United States. Methods Patients with DD undergoing sleeve gastrectomy were matched to adolescents without DD. Chart review was performed to determine etiology and severity of DD, weight, and body mass index (BMI) change in each group at 3, 6, 9, and 12 months postoperatively. One-year emergency department visits, readmissions, and reoperations were reviewed. Results Ten patients with DD and 44 patients without DD underwent sleeve gastrectomy between 2008 and 2017. Six patients with DD (60%) had mild cognitive impairment, 3 patients (30%) had moderate cognitive impairment, and 1 patient (10%) had severe cognitive impairment. Patients were 81.5% female, had a mean age of 17.3 years, and had a preoperative BMI of 48.6 kg/m2. Preoperative BMI was similar in the 2 groups, and percent BMI reduction at 1 year was −29% (95% confidence interval: −35 to −23) and −26% (95% confidence interval: −29 to −23) in groups with and without DD respectively (group by time interaction, P = .27). Conclusion Adolescents with DD experience similar 1-year weight loss and adverse events following sleeve gastrectomy to adolescents without DD. Understanding the long-term outcomes for this population is crucial to ensure appropriate implementation of surgical weight loss programs.