Removing Barriers to Bariatric Surgery: The Role of Intellectual and Developmental Disabilities on Outcomes in Adolescents and Young Adults

Metabolic and bariatric surgery (MBS) is an effective means of achieving weight loss for adolescents and young adults (AYA) with obesity. Intellectual and developmental disabilities (IDD) are not absolute contraindications for MBS treatment in AYA with obesity. We sought to determine whether a diagnosis of IDD is associated with weight loss after MBS. We conducted a retrospective chart review of patients ≤ 21 years who underwent MBS at a single institution, comparing outcomes among those with IDD and those without. A total of 103 patients were included. Nine were diagnosed with IDD preoperatively: two had Autism, two had Down Syndrome and five had unspecified IDD. Preoperative BMI was comparable in patients with IDD and those without. Postoperative weight loss was equivalent between AYA with and without IDD at 12 (24.7% vs. 28.9%), 24 (30.9% vs. 25.1%) and 36 months (25.3% vs. 20.8%). At 12 months, four non-IDD patients were deficient in B1, B12 or iron, while no patients with IDD were deficient in any micronutrients. AYA patients with IDD may derive equal weight loss benefit from MBS with comparable micronutrient status. Barriers to MBS in AYA with IDD need to be addressed to expand obesity treatment.