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Original Article |

Evaluating Tonsillectomy as a Risk Factor for Childhood Obesity

Jessica Levi, MD; Steven Leoniak, MD; Richard Schmidt, MD
Arch Otolaryngol Head Neck Surg. 2012;138(10):897-901. doi:10.1001/2013.jamaoto.252.
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Published online

Objective  To investigate weight gain and any increased risk of obesity in children who have undergone tonsillectomy.

Design  Retrospective chart review.

Setting  Tertiary care pediatric hospital.

Patients  The study included 200 children aged 2 to 12 years who were undergoing tonsillectomy and 200 age- and sex-matched controls. All children had a preoperative body mass index (BMI) and a postoperative BMI recorded 6 to 18 months after surgery.

Main Outcome Measures  The BMI percentile (BMI%) for age was analyzed between and within groups. A Wilcoxon matched-pairs test was used to analyze BMI% before and after tonsillectomy. A Mann-Whitney test was used to compare BMI% between the study and the control groups. An odds ratio (OR) was used to compare overweight (≥85%) and obese (≥95%) patients before and after surgery. A correlation analysis was used to examine the relationship between age and weight gain.

Results  The BMI% did not differ significantly between the study and the control groups before surgery (P = .14). The BMI% in the study group increased significantly after tonsillectomy (P < .001). Although older children had a higher BMI% than matched controls before surgery, they had a smaller change in BMI% than younger children after tonsillectomy (P = .004). The odds of a child being overweight (OR, 1.23; P = .36) or obese (OR, 1.44; P = .12) were not significantly different before or after tonsillectomy.

Conclusion  Children, particularly younger ones, gained weight after tonsillectomy, but the odds of a child being overweight or obese after tonsillectomy were no different than they were before surgery.

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Figures

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Figure 1. Body mass index percentiles (BMI%) in the study group before and after surgery and in the control group at baseline (T0) and 6 to18 months after baseline (T1). In the study group, the mean BMI% increased to 72.6 after surgery (from 66.9) (P < .001). The second BMI% (65.9) in the comparison group was not significantly different from the first BMI% (63.6) (P = .37).

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Figure 2. The percentage of overweight children (≥85th percentile) before and after tonsillectomy. Forty-one percent of children were overweight before surgery compared with 46% after surgery. This difference was not significant (odds ratio, 1.23; 95% CI, 0.82-1.82;  = .36).

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Figure 3. Percentage of obese children (≥95th percentile) before and after tonsillectomy. Twenty-five percent were obese before surgery, and 33% were obese after surgery. This difference was not significant (odds ratio, 1.44; 95% CI, 0.93-2.22; P = .12).

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Figure 4. Change in body mass index percentile (BMI%) as a function of age.

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Figure 5. Change in body mass index percentile (BMI%) as a function of baseline BMI%.

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