Tonsillectomy does not lead to unhealthy weight in children

By Sally Robertson, B.Sc.Oct 23 2012

Tonsillectomy leads to weight gain in children, but does not increase the likelihood of overweight or obesity, report researchers.

In addition, tonsillectomy-associated weight gain only seems to occur in younger rather than older children, write Richard Schmidt (DuPont Hospital for Children, Wilmington, Delaware, USA) and colleagues in The Archives of Otololaryngology ‑ Head and Neck Surgery.

A recent literature review suggested a link between tonsillectomy in children and subsequent risk for obesity, explain the researchers.

"Considering the impact of the childhood obesity 'epidemic' and the frequency of tonsillectomy in children, this is certainly an alarming prospect," they say.

In a retrospective study of 200 randomly selected children, aged 2‑12 years, who underwent tonsillectomy, the team analyzed post-procedure weight gain among the patients compared with age-matched controls.

The mean body mass index (BMI) percentile for age significantly increased from 66.9 before tonsillectomy to 72.6 when measured 6 to 18 months after the procedure, while there was no significant increase in mean BMI percentile for age between these two time points in the comparison group, at 63.6 and 65.9, respectively.

However, there was no significant difference in the proportion of children who were overweight (BMI percentile ≥85) before versus after surgery, at 21% and 23%, respectively. Similarly, there was no significant difference in the proportion found to be obese before compared with after surgery, at 13% versus 17%.

The team found that age negatively correlated with postoperative change in BMI percentile, with younger children (aged 2‑4 years) demonstrating greater weight gain after surgery than older children (aged 5‑12 years). Younger children had an increase in BMI percentile from 60.2 before tonsillectomy to 70.6 after the procedure, while there was no significant change in BMI percentile before versus after tonsillectomy in older children.

"These data could suggest that younger children, who are more likely to undergo tonsillectomy for sleep-disordered breathing or dysphagia (possibly associated with growth failure), are gaining weight after surgery once the obstruction is relieved," comment the researchers

On the other hand, "older children, who are more likely to undergo tonsillectomy for chronic tonsillitis and who are already at a higher BMI [percentile], have less change in weight."

The team suggests that a prospective study could help elucidate these issues.

In the meantime, otolaryngologists should appreciate that postoperative weight gain does occur in children after tonsillectomy, although it is unlikely to cause an increased risk for obesity after surgery.

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