Weight Loss Surgery in Youth Linked to Bone Weakening

Common Weight Loss Surgery Weakens the Bones of Young People

According to a recent study published in a reputable medical journal, weight-loss surgery, which is commonly performed on obese adolescents and young adults, has been found to have a detrimental impact on bone health. The study specifically focused on the long-term effects of sleeve gastrectomy, the most commonly performed type of weight-loss surgery, on bone marrow fat and bone strength in adolescents and young individuals.

Sleeve gastrectomy is a surgical procedure that involves removing about 75% to 80% of the stomach to limit food consumption and promote weight loss. It results in the formation of a round stomach in the shape of a sleeve or tube. The number of sleeve gastrectomy surgeries performed each year has been steadily increasing, surpassing gastric bypass as the main weight-loss procedure.

For this study, participants between the ages of 13 and 24 years were recruited from 2015 to 2020. These individuals were moderately to severely obese, with a BMI of 35 or higher. The study included 54 participants, with 29 in the control group and 25 undergoing sleeve gastrectomy. Of the participants, 41 were female. The surgery group consisted of individuals with at least one obesity-related comorbidity or a BMI of 40 or higher, while the control group was obese but did not plan to undergo sleeve gastrectomy and received exercise and dietary counseling instead.

Before the surgery and 24 months after, the participants underwent blood tests, physical examinations, and quantitative computed tomography (QCT) of the lumbar spine. QCT is an accurate method for measuring volumetric bone mineral density and conducting finite element analysis to assess bone strength. Additionally, proton MR spectroscopy was used to evaluate lumbar spine bone marrow fat as it can serve as a biomarker for bone quality.

The results showed that two years after surgery, the BMI of the adolescents and young adults had decreased, while there was a slight increase in the control group. However, the group that underwent sleeve gastrectomy experienced a significant increase in bone marrow fat and a decrease in strength estimates and bone density in the lumbar spine compared to the control group. This suggests that weight-loss surgery has a negative impact on bone health, with reduced bone strength and elevated bone-weakening markers.

Building bone mass is crucial during adolescence, and deficits in bone accrual during this period can have long-term consequences for bone health and the risk of fractures later in life. As bariatric surgery becomes more common in adolescents, it is essential to emphasize its impact on bone health, especially to medical professionals who will continue to provide regular medical care for these individuals.

In conclusion, the study highlights the potential detrimental effects of weight-loss surgery, specifically sleeve gastrectomy, on bone health in obese adolescents and young adults. The findings suggest that these individuals may experience reduced bone strength and increased bone marrow fat following surgery. As such, healthcare providers should consider the long-term implications of weight-loss surgery on bone health and provide appropriate monitoring and interventions to mitigate any negative effects. Further research is needed to better understand the mechanisms behind these findings and develop strategies to optimize bone health in individuals undergoing weight-loss surgery.


1. Journal Reference: DOI: 10.1148/radiol.223256