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  5. Bariatric Surgery for Teens with Severe Obesity Study: Teen-LABS

Bariatric Surgery for Teens with Severe Obesity Study: Teen-LABS

NIDDK funded the Teen-LABS (Longitudinal Assessment of Bariatric Surgery) study to look at the short- and long-term risks and benefits of weight-loss surgery, also called metabolic and bariatric surgery, in teens, including gastric band, gastric sleeve, and gastric bypass. Teen-LABS is the first large-scale study of this procedure in teens who have severe obesity (a much greater-than-normal amount of body fat) and serious weight-related health problems, such as prediabetes; type 2 diabetes; cardiovascular disease (heart and blood vessel disease); sleep apnea (breathing problems during sleep); nonalcoholic fatty liver disease, or NAFLD (also referred to as metabolic dysfunction-associated steatotic liver disease, or MASLD); or other conditions.

For teens with severe obesity, lifestyle changes such as following a healthy eating plan for weight loss and being more active are important. However, if not enough weight is lost to improve health, then additional methods of managing weight such as surgery or prescription medications to treat overweight and obesity may be considered. Teens and their families should talk with their primary care doctor about options for managing weight.

Results

Researchers found major improvements in weight, heart health, prediabetes, type 2 diabetes, high blood pressure, high blood cholesterol, and abnormal kidney function 3 years after weight-loss surgery in teens who were in the study.

Five years after weight-loss surgery, researchers compared results for teens who were in the study and had gastric bypass surgery to adults who had the same procedure in the LABS (Longitudinal Assessment of Bariatric Surgery) study. Adults in the LABS study reported having obesity when they were teens but did not have surgery until they were adults. Researchers found that earlier gastric bypass surgery may have greater benefits compared to waiting until later in life.

  • Teens lost 26% of their bodyweight and adults lost 29% of their bodyweight.
  • Teens with type 2 diabetes before surgery were more likely than adults to better manage their blood glucose, also called blood sugar, without the use of diabetes medicines. After surgery no teens needed diabetes medications compared to 88% of teens before surgery. After surgery 26% of adults needed diabetes medications compared to 79% of adults before surgery.
  • Teens were more likely than adults to no longer have high blood pressure or take blood pressure medications. After surgery 11% of teens needed blood pressure medications compared to 57% of teens before surgery. After surgery 33% of adults needed blood pressure medications compared to 68% of adults before surgery.

Researchers also identified some risks from surgery. Five years after surgery, teens were more likely than adults to need additional abdominal surgery, most commonly gallbladder removal. Teens were also more likely to have low iron and vitamin D levels, possibly because teens may be less likely to take enough vitamin D and mineral supplements after surgery. There was a similar death rate for teens and adults.

Ten years after weight-loss surgery, study participants continued to see sustained weight loss and resolution of common obesity-related health problems, with similar results for gastric bypass and sleeve gastrectomy surgeries.

  • Teens sustained an average of 20% reduction in their body mass index (BMI).
  • Teens had a 55% reduction in type 2 diabetes, which was much higher than the reduction of type 2 diabetes in adults who had weight-loss surgery. Adults had 18% reduction in type 2 diabetes at 7 years and 12.7% reduction at 12 years, according to another NIH-funded study. Because complications from type 2 diabetes tend to progress more rapidly in young people, these findings demonstrate greater health benefits and durability of metabolic bariatric surgery in youth than would be expected in similarly treated adults.
  • Teens had a 57% reduction of hypertension and 54% reduction of abnormal lipids.

Study Size, Participant Demographics, Study Design, and Follow-up

About 240 teens, ages 13 to 19, were enrolled in Teen-LABS between 2006 and 2012. About 160 teens in the study had weight-loss surgery at five medical centers

  • Cincinnati Children’s Hospital Medical Center, Ohio
  • Texas Children’s Hospital, Texas
  • Children’s Hospital of Alabama, Alabama
  • University of Pittsburgh Medical Center, Pennsylvania
  • Nationwide Children’s Hospital, Ohio

Before joining the study, all of the teens made the decision to have weight-loss surgery. While the study did not provide their surgeries, all surgeries took place at one of the Teen-LABS’ clinical locations specialized in the surgical evaluation and management of young people with severe obesity. Their health was then evaluated as part of the study before and after surgery. The surgeries were performed between 2007 and 2012.

In 2016, NIDDK extended funding for Teen-LABS for several more years to allow the researchers to gain additional information from participants on longer-term benefits and risks from the surgery. For example, researchers assessed

  • how long the weight loss lasted
  • whether improvements in quality of life, diabetes, blood pressure, and other conditions were long lasting
  • whether other health problems occurred

These results help support clinical guidance for treating teens with severe obesity. Additional research findings on how surgery compares to use of medications and longer-term health outcomes of weight-loss surgery will guide treatment decisions to improve the health of teens with severe obesity.

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Last Reviewed March 2025