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Weight Loss Surgery in Adolescents With Extreme Obesity

Active, not recruiting
Conditions
Obesity
Extreme Obesity
Interventions
Procedure: bariatric surgery
Other: conservative care
Registration Number
NCT02062164
Lead Sponsor
Prof. Dr. Martin Wabitsch
Brief Summary

The use of bariatric surgery in adolescents is controversial. On one side, bariatric surgery is the only effective treatment to achieve sustained weight loss in adults with extreme obesity. Comorbidities are reversed and mortality is reduced. In adolescents, bariatric surgery is equally effective; however, due to the paucity of long-term data, the long-term effects and risks are unknown. Thus, due to surgical risk and ethical implications, bariatric surgery is considered experimental in Germany. Nevertheless, case volumes are increasing.

The aim of this study is to evaluate the benefits and risks of adolescent bariatric surgery in the context of a structured preparation and follow-up program. The study is a subproject of the study "Medical and psychosocial implications of adolescent extreme obesity - acceptance and effects of structured care" (DRKS00004172). At 5 German university centers (Ulm, Datteln, Berlin, Essen, Leipzig), youth who undergo bariatric surgery and are participants in the overall project will be enrolled in a structured preparation and follow-up program. The program is designed to improve adherence and compliance and will result in comprehensive follow-up data. In addition to the data gathered in the overall project, subjects participating in subproject 3 will undergo assessments pertinent to bariatric surgery, as proposed in the American Teen-LABS study (http://www.cincinnatichildrens.org/ research/divisions/t/teen-labs/default/). Comparison will be made with BMI matched adolescents who participate in the overall project but do not undergo bariatric surgery.

In November 2014 recruitment for the overall project was completed. However, patients interested in bariatric surgery will still be recruited until September 2016. There assessment will be the same as for patients recruited earlier. However, in an amendment in December 2014, the frequency of assessment via questionnaire was reduced from biannually to annually. In addition, a travel reimbursement of 30€ for each study visit was implemented.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
66
Inclusion Criteria
  • BMI ≥ 35 kg/m2 with severe comorbidity or BMI ≥ 40 kg/m2 with relevant comorbidity
  • completed longitudinal growth
  • stable social surroundings
  • exhaustion of conservative treatment
  • participation in the project "Adolescents with extreme Obesity"
  • adequate compliance and adherence
Exclusion Criteria
  • treatable causative condition
  • unstable medical, psychosocial or psychiatric comorbidity
  • alcohol or drug abuse
  • pregnancy
  • contraindication for bariatric surgery

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
bariatric surgery groupbariatric surgerysubjects who participate in the overall project and undergo bariatric surgery
conservative care groupconservative caresubjects who participate in the overall project and do not undergo bariatric surgery
Primary Outcome Measures
NameTimeMethod
BMI change from baseline1 year postoperative
Secondary Outcome Measures
NameTimeMethod
changes in somatic comorbidityevery 12 months for 9 years

Will be assessed via standardized physical examination, laboratory and apparative tests, and standardized patient questionnaires.

changes in psychosocial comorbidityevery 12 months for 9 years

Will be assessed via standardized patient questionnaires.

changes in psychiatric comorbidityevery 12 months for 9 years

Will be assessed via standardized psychiatric evaluation and standardized and validated patient questionnaires.

vitamin deficienciesevery 6 months for 9 years

Will be assessed via patient questionnaire and laboratory studies.

adherence with postoperative recommendations on supplements, doctors visits and nutritionevery 12 months for 9 years

Will be assessed via patient questionnaire.

hunger, food tolerance, gastrointestinal symptoms, dumpingevery 12 months for 9 years

Will be assessed via patient questionnaire.

BMIevery 6 months for 9 years
schooling, vocation, psychosocial situation, functional impairmentsevery 12 months for 9 years

Will be assessed via standardized patient questionnaire.

eating behaviorevery 12 months for 9 years

Will be assessed via validated questionnaire (EDE-Q).

changes in quality of life: SF36every 12 months for 9 years

Will be assessed via validated questionnaires (SF36).

peri- und postoperative complicationsevery 12 months for 9 years

Will be assessed via physician questionnaires.

exerciseevery 12 months for 9 years

Will be assessed via validated questionnaire (IPAQ).

changes in quality of life: IWQOLevery 12 months for 9 years

Will be assessed via validated questionnaires (IWQOL).

Trial Locations

Locations (5)

Vestische Kinderklinik, University of Witten/Herdecke

🇩🇪

Datteln, Germany

University Hospital Leipzig

🇩🇪

Leipzig, Germany

Dept for Pediatrics and Adolescent Medicine, University of Ulm: Interdisciplinary obesity clinic

🇩🇪

Ulm, Germany

University Duisburg-Essen

🇩🇪

Essen, Germany

Ambulatory Obesity Program, Charité University, Berlin

🇩🇪

Berlin, Germany

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