Severe obesity in adolescents is a public health crisis of increasing concern. Cardiac maladaptation, such as left ventricular hypertrophy, increases the risk of future cardiovascular disease. This study aims to evaluate the impact of weight loss surgery on cardiac geometry in morbidly obese adolescents.

A single-centre, randomised controlled trial titled comparing laparoscopic adjustable gastric banding with multidisciplinary lifestyle intervention against a control group with multidisciplinary lifestyle intervention alone. The trial included severely obese adolescents aged 14–16 who had not responded to a minimum of 12 months of multidisciplinary lifestyle intervention. The primary outcome measured was the percentage change in total body weight one year after surgery. Left ventricular geometry was evaluated ultrasonographically before and one year after bariatric surgery.

In the intervention and control group, a total of 10 and 8 patients received both the baseline and follow-up ultrasonographic examination. BMI significantly decreased in the intervention group compared to the control group (−6.75; 95% CI: -10.28 – −3.23). Moreover, left ventricular mass index (−8.21; 95% CI: −15.43 – −0.98) and relative left ventricular wall thickness (−0.04; 95% CI: −0.07 – 0.00) significantly decreased within the intervention group, reflecting amelioration of adverse remodelling, albeit without statistically significant intervention effect when compared to the control group.

Significant weight loss through bariatric surgery may improve left ventricular geometry in severely obese adolescents. These findings support the potential of bariatric surgery not only for reducing weight loss but also for improving cardiac health.