Functional mobility and pain are improved for 6 years after adolescent bariatric surgery

Objective: The long-term durability of improvements in functional mobility and musculoskeletal pain for adolescents after metabolic and bariatric surgery (MBS) is unknown. Methods: We used the Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) study to determine the change in mobility and pain among adolescents who underwent MBS. From standardized 400-m walk tests, we analyzed walk time, heart rate (HR) parameters, and musculoskeletal pain. Results: The mean walk time improved from 383 s (95% CI: 368–399) prior to surgery to 351 s (95% CI: 330–372) by 6 years. The mean resting HR was 90 beats per minute (bpm; 95% CI: 87–93) preoperatively and decreased to 80 bpm (95% CI: 76–84) by 6 years. The risk of any musculoskeletal pain decreased from 37.2% (95% CI: 25.5%–48.9%) to 11.0% (95% CI: 4.3%–17.6%) by 6 years. Mediation analysis revealed that the effect of time since surgery on walk time, resting HR, and HR recovery occurred through a weight-dependent mechanism. For posttest HR and HR difference, there was both a significant weight-dependent and weight-independent mechanism. The effect of surgery on the risk of musculoskeletal pain occurred through a weight-independent mechanism. Conclusions: Adolescents who underwent MBS experienced significant, durable improvement in mobility and pain, despite weight regain. Our models suggest that improvements may occur through a weight-independent mechanism.