ESPE Yearbook of Paediatric Endocrinology

Obesity (Silver Spring). 2025 Jun;33(6):1126-1135. doi: 10.1002/oby.24285 https://pubmed.ncbi.nlm.nih.gov/40259728/

Brief Summary: Metabolic and bariatric surgery (MBS) is known to offer improvement in functional mobility and musculoskeletal pain in the short term, but the durability of the effects in the long term and in the setting of weight regain are unknown. The prospective, multicenter observational cohort study Teen Longitudinal Assessment of Bariatric Surgery (Teen-LABS) followed 205 adolescents (aged 13 to 19 years) for up to 6 years after metabolic and bariatric surgery. Sustained improvements in functional mobility and walking-related musculoskeletal pain were observed, despite modest weight regain.

Adolescents with severe obesity are at elevated risk for mobility limitations and musculoskeletal pain [1,2], both of which significantly impair participation in physical activity and overall quality of life². The Teen-LABS cohort study offers longitudinal data demonstrating that MBS yields sustained improvements in these functional domains over a six-year follow-up period. Notable findings include a significant reduction in 400-meter walk time, improved post-exercise heart rate recovery, and a substantial decrease in self-reported musculoskeletal pain, effects that persisted even in individuals who experienced partial weight regain. The mediation analysis indicates that several observed benefits, such as reductions in immediate post-exercise heart rate and musculoskeletal discomfort, were mediated by weight-independent mechanisms. This suggests that physiological factors beyond weight loss itself, such as decreased systemic inflammation or altered biomechanical load distribution, may play a critical role in functional improvement after MBS. These findings underscore the long-term functional benefits of MBS during adolescence and emphasize the complex interplay between body weight, physiological adaptations, and physical function. Further research into the underlying biological mechanisms responsible for these weight-independent effects could inform the development of novel therapeutic strategies, both surgical and non-surgical, aimed at enhancing physical function and reducing pain in adolescents with severe obesity.

References: 1. Schmidt H, Menrath I, Wiegand S, Reinehr T, Kiess W, Hebebrand J, von Schnurbein J, Holl R W, Holle R, Scherag A, Wabitsch M, Brandt-Heunemann S. Youths with Extreme Obesity: A High-Risk Group for Pain and Mental Health Impairments. Obes Facts. 2025;18(1):21-30. doi: 10.1159/000540888.2. Bout-Tabaku S, Michalsky M P, Jenkins T M, Baughcum A, Zeller M H, Brandt M L, Courcoulas A, Buncher R, Helmrath M, Harmon C M, Chen M K, Inge T H. Musculoskeletal Pain, Self-reported Physical Function, and Quality of Life in the Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) Cohort. JAMA Pediatr. 2015 Jun;169(6):552-9., doi: 10.1001/jamapediatrics.2015.0378.