Resting Energy Expenditure Profiles in Pediatric Patients with Obesity Undergoing Sleeve Gastrectomy

Background: Obesity is a prevalent medical condition among the pediatric population. Metabolic and bariatric surgery is recommended to treat severe obesity. Resting energy expenditure (REE) plays a vital role in weight homeostasis. This study aims to assess the impact of sleeve gastrectomy (SG) on REE in pediatric patients with severe obesity while comparing REE values with body composition. Methods: Participants were recruited from the Pediatric Weight Management Clinic and Bariatric Surgery Clinic at Lucile Packard Children's Hospital. REE was measured using indirect calorimetry. Body composition was assessed using dual energy X-ray absorptiometry scans. Data were collected prospectively and analyzed using a generalized linear model and correlation analyses. Results: Thirty-six participants with severe obesity were included. Correlation analyses showed significant differences in baseline REE/kg between age groups, with higher REE/kg in participants <16 years. No significant correlations were observed between pre-SG REE/kg and degree of weight loss post-SG. Pre-SG %lean body mass positively correlated with REE/kg. There was no significant change in REE/kg following SG with weight loss. Conclusions: SG remains an effective intervention for managing severe obesity. This study found no significant changes in REE after SG. Future research should focus on larger longitudinal studies to enhance understanding of the metabolic effects of SG in pediatric patients while optimizing strategies for improved health outcomes.