Abstract
OBJECTIVE: To assess the effect of bariatric surgery (BS) on health-related quality of life (HRQoL) and depressive symptoms in adolescents in a randomized controlled trial, comparing laparascopic adjustable gastric banding (LAGB) with multidisciplinary lifestyle intervention (MLI) to MLI alone. METHOD: Adolescents with severe obesity were referred to our study after failure of conservative therapy and randomized into the intervention group (LAGB and MLI) or the control group (MLI). Anthropometric measurements, questionnaires evaluating HRQoL, and depressive symptoms were taken at baseline, 12 months, and 24 months. RESULTS: Significant differences between the study groups in body mass index (BMI), HRQoL, and depressive symptoms at 12 months were observed. After 24 months, this difference persisted for BMI (mean difference -3.43, 95% CI -6.78, -0.80) and BMI z score (-0.45, 95% CI -0.75, -0.14) but not for HRQoL (7.80, 95% CI -1.93, 17.53) and depressive symptoms (-4.18, 95% CI -11.68, 3.31). CONCLUSION: BS combined with MLI was superior in comparison to MLI alone to reduce BMI and to mediate improvement in HRQoL and self-reported depression after 12 months. However, only the difference in BMI was sustained after 24 months. This indicates that LAGB in combination with MLI does not show superiority over MLI alone for the improvement in HRQoL and depressive symptoms in adolescents with severe obesity over 2 years. CLINICAL TRIAL REGISTRATION INFORMATION: Bariatric surgery versus conservative treatment in morbidly obese children; https://onderzoekmetmensen.nl/en/node/47066/pdf.