Adolescents with higher levels of certain types of polyfluoroalkyl substances (PFAS) in their blood prior to bariatric surgery were significantly more likely to regain weight after the procedure than those with lower levels, a new study has found.
PFAS – synthetic chemicals used in many consumer products labeled as stain or grease resistant, waterproof, or nonstick – are present in most peopleS blood and are associated with endocrine disruption and metabolic dysregulation, lead author Brittney Baumert, phd, MPH, a postdoctoral research fellow in population and public health sciences at the Keck School of Medicine of the University of Southern California in Los Angeles, and colleagues wrote.
these compounds,nicknamed forever chemicals because they’re resistant to breaking down, are associated with reduced weight loss during dietary interventions and increased weight gain after those interventions in adults, but their weight-loss effect hasn’t been studied in adolescents, who are still undergoing developmental and metabolic changes that could make them more vulnerable to PFAS, the researchers added.
“With the use of weight-loss interventions increasing for the treatment of obesity, identifying modifiable risk factors for adolescents at greatest risk of regaining weight is especially important, as such insights could inform targeted strategies to enhance and sustain long-term success of these interventions,” Baumert told Medscape Medical News.The rapid, substantial weight loss induced by bariatric surgery offered researchers an opportunity to study how PFAS might affect postoperative weight trajectories in teenagers, the researchers wrote.
For their study, published online in Obesity, Baumert and colleagues followed 186 adolescents who underwent bariatric surgery for obesity.The participants were part of the Teen-Longitudinal Assessment of Bariatric surgery cohort who underwent the procedure between 2007 and 2012. The mean age of the study population was 17.1 years, 76.3% were girls, and 72% were white individuals. The primary outcome was weight regain after 5 years.
Researchers measured plasma concentrations of eight PFAS at baseline prior to surgery. the substances included three perfluoroalkyl sulfonic acids – perfluorooctane sulfonic acid (PFOS), perfluorohexane sulfonic acid (PFHxS), and perfluoroheptane sulfonic acid (PFHpS), as well as five perfluoroalkyl carboxylic acids – perfluorooctanoic acid, perfluorodecanoic acid, perfluoroheptanoic acid (PFHpA), perfluorononanoic acid (PFNA) and perfluoroundecanoic acid.
More Weight Regain With PFAS Exposure
Higher concentrations of the three sulfonic acid-containing compounds (PFOS,PFHxS,and PFHpS) individually and in sum were significantly associated with larger annual BMI regain after surgery than lower levels during the period from 1-5 years after surgery.For exmaple, a baseline PFOS concentration of 1.45 log2 ng/mL was associated with an estimated annual BMI regain of 1.34 compared with an estimated BMI regain of 1.84 per year for a baseline PFOS concentration of 2.94 log2 ng/mL (P = .0497).
In addition, higher levels of the three sulfonic acid-containing chemicals were significantly associated with an increased waist circumference and reduced total percentage weight lost 1-5 years after surgery.For the carboxylic acid-containing compounds, BMI regain during the 1-5 years after surgery trended lower the higher the chemical concentration level was at baseline, although the differences didn’t reach statistical significance, except for pfhpa individually. The baseline PFHpA concentration of -2.18 log2 ng/mL was associated with an estimated annual BMI regain of 1.43 compared with a regain of 1.65 per year at the lower baseline concentration of -4.85 log2 ng/mL (P = .05).