Changes in Body Mass Index Following Pediatric Tonsillectomy for Obstructive Sleep Apnea

The objective was to evaluate postoperative BMI trends (in kg/m²) in pediatric patients with obstructive sleep apnea (OSA) undergoing tonsillectomy by assessing BMI trends.

This study was a retrospective chart review.

This review took place at a single-institution tertiary care center.

Eight hundred four pediatric patients who underwent tonsillectomy at Cooper University Hospital between January 2020 and January 2022 were grouped by preprocedure diagnosis of OSA. Patient age, sex, BMI (kg/m²) at baseline and at one-, three-, six-, and 12-month follow-ups, and postoperative pain metrics were collected.

For all 804 patients aged 0 to 17 years old, there were significant increases in BMI values at one, three, six, and 12 months postoperatively from a baseline of 21.2 kg/m². BMI increased at one month postoperatively (difference = 0.46921 kg/m² (0.02183-0.9165), p = 0.0399), three months (difference = 0.6858 kg/m² (0.1738-1.1978), p = 0.0088), six months (difference = 1.0025 kg/m² (0.359-1.646), p = 0.0023), and 12 months (difference = 1.4458 kg/m² (0.8234-2.0682), p < 0.0001). Stratified by age, 274 (34%) patients aged 0 to four years old with OSA had no significant changes from a baseline BMI of 17 kg/m² at one or three months postoperatively. BMI increased at six months (difference = 0.8626 kg/m² (0.1929-1.5324), p = 0.012) and at 12 months (difference = 1.0068 kg/m² (0.3047-1.7089), p = 0.0052). Three hundred five (38%) patients aged five to nine years old with OSA had no significant changes from a baseline BMI of 20.2 kg/m² at one or six months postoperatively. BMI increased at three months (difference = 1.185 kg/m² (0.03143-2.3386), p = 0.0441) and at 12 months (difference = 1.0398 kg/m² (0.3658-1.7138), p = 0.0027). Two hundred twenty-five (28%) patients aged 10 to 17 years old with OSA had no significant changes from a baseline BMI of 28.2 kg/m² at one, three, or six months postoperatively. BMI increased at 12 months (difference = 2.5252 kg/m² (0.769-4.2813), p = 0.0053).

Tonsillectomy in pediatric patients with OSA is associated with significant postoperative BMI increases, highlighting the need for diagnosis-specific counseling and longitudinal weight monitoring.