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Key Factors in Weight Gain After Pediatric Tonsillectomy

Author Information (click to view)

Stacey L. Ishman, MD, MPH, FAAP

Associate Professor, Otolaryngology-Head and Neck Surgery
Director, Center for Snoring and Sleep Surgery
Johns Hopkins University School of Medicine

Stacey L. Ishman, MD, MPH, FAAP, has indicated to Physician’s Weekly that she has no financial disclosures to report.

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Stacey L. Ishman, MD, MPH, FAAP (click to view)

Stacey L. Ishman, MD, MPH, FAAP

Associate Professor, Otolaryngology-Head and Neck Surgery
Director, Center for Snoring and Sleep Surgery
Johns Hopkins University School of Medicine

Stacey L. Ishman, MD, MPH, FAAP, has indicated to Physician’s Weekly that she has no financial disclosures to report.

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There is concern that adenotonsillectomy may be associated with significant weight gain after surgery in children.

Studies have indicated that adenotonsillectomy may be associated with significant weight gain after surgery, a problem that can be concerning for both parents and patients. Previous research also suggests that the postoperative weight gain associated with adenotonsillectomy occurs mostly in children who undergo the procedure as treatment for diagnosed obstructive sleep apnea (OSA).

“Potentially worrisome weight gains following adenotonsillectomy occurred primarily in children under the age of 6 years who were underweight or normal weight to begin with.”

At the 2012 annual meeting of the American Academy of Otolaryngology–Head and Neck Surgeons, my colleagues and I presented data from a study involving a large population of children undergoing adenotonsillectomy and the demographic factors that may contribute to weight gain. We analyzed medical records of children aged 6 months to 18 years who had their tonsils removed between 2008 and 2011. These data were then refined to only include medical records for children who were routinely examined for at least 6 months after their surgery and had recorded height and weight measurements. All patients in the study had a history of OSA or recurrent tonsillitis.

Who’s At Risk for Weight Gain?

Results of our analysis showed that, on average, patients had a weight gain of 0.5 to 2.0 lbs— equivalent to a 0.4- to 0.6-point increase in BMI scores—after their surgery. Importantly, the gains that were observed were not dependent on whether the children had OSA or recurrent tonsillitis. In a multiple linear regression analysis that controlled for gender and height, only age was significantly and negatively associated with changes in BMI. Potentially worrisome weight gains following adenotonsillectomy occurred primarily in children younger than 6 who were underweight or normal weight to begin with.

Putting Findings Into Perspective

While the weight gain after pediatric adenotonsillectomy that was seen in our study might appear to be small, it’s important to recognize that even minor weight increases can be quite worrisome, especially to parents. That said, our findings should help alleviate rising concerns from parents that adenotonsillectomy may aggravate health problems in children who are already overweight. For parents of adolescents requiring the surgery who are normal weight, there should be less concern for new-onset obesity to develop after the procedure. Parents with younger children and those with overweight kids should be instructed by their physicians to closely observe their child’s diet after surgery and make caloric adjustments when necessary.

More research is needed because the underlying causes of weight-gain after adenotonsillectomy are still unknown for these patients. Further investigating the relationship between weight gain and demographic factors and paying special attention to the impact of age with prospective evaluations would be of benefit. My colleagues and I plan to prospectively monitor children immediately after surgery to determine which factors or interventions result in weight gain after adenotonsillectomy. We’re also taking measures to ensure that those who are overweight do not gain weight after their procedure.

Readings & Resources (click to view)

Levi J, Leoniak S, Schmidt R. Evaluating tonsillectomy as a risk factor for childhood obesity. Arch Otolaryngol Head Neck Surg. 2012;138:897-901.

Wei JL. Weight gain after tonsillectomy: myth or reality? Interpreting research responsibly. Otolaryngol Head Neck Surg. 2011;144:855-857.

Wijga AH, Scholtens S, Wieringa MH, et al. Adenotonsillectomy and the development of overweight. Pediatrics. 2009;123:1095-1101.

Fernandes AA, Alcântara TA, D’Avila DV, D’Avila JS. Study of weight and height development in children after adenotonsillectomy. Braz J Otorhinolaryngol. 2008;74:391-394.

Roemmich JN, Barkley JE, D’Andrea L, et al. Increases in overweight after adenotonsillectomy in overweight children with obstructive sleep-disordered breathing are associated with decreases in motor activity and hyperactivity. Pediatrics. 2006;117:e200-e208.

 

52 Comments

  1. I had my tonsils and adenoids removed at age 5. Prior to the surgery i weighed 45 lbs. A year later, i had gained 45 lbs, and continued to gain weight my entire life until I had weight loss surgery at 42… i weighed 290lbs. Additionally, a month after the surgery I had to have 9 fillings… a month before the surgery, my teeth were perfect. I continued to have trouble with cavities until my 20s, usually 4-5 every time I got a cold or virus. There is most definitely a connection.

    Reply
  2. I was a normal size child at 5, not skinny but certainly quite slim. I had recurring tonsilitis and had my t&a’s removed at 7. By 10 I was obese and I never managed to lose the weight until I was 16 and sought help (drug) from my doctor. I haven’t been overweight now for decades (I am 52) but I have to watch it all the time. I attend gym, have a normal active life – in my job I am on my feet all the time – but the moment I deviate from “observed” eating as I call it, i will start gaining weight.

    Reply
  3. I am 16 and got my tonsils removed when I was 5 due to breathing problems. My weight was normal and average for my age prior to the surgery. After the surgery although my eating habits hadn’t changed I started taking on weight. It has considerably affected my entire childhood and teenagehood. I am now overweight but far from obese due to constant dieting. However I find it extremely hard to lose any weight, no matter the diet. I wish I hadn’t gotten my tonsils removed since after reading all your comments I’m pretty sure that it was what gave a start to my weight gain. I also wish more studies were done on this to try to find solutions. I feel like it is possible that my metabolism was slowed down. Anybody knows how any solution to lose that weight ?

    Reply
  4. Our granddaughter (now 7 years old) had the above surgical procedure completed at age five due to OSA. Up until that time she had no weight issues. Even though she still remains very physically active she is gaining weight at an alarming rate and has become obese. She is extremely intelligent, cheerful and outgoing but it has become apparent this issue is starting to affect her emotional well being. She too can no longer wear clothing designed for her age group but must wear women’s fashions (sized small and medium). After reading Dr. Ashman’s documentation and the comments submitted, I feel this issue needs to be addressed by the medical professionals in the very near future.

    Reply
  5. There must be a connection between the surgery and the weight gain. There is a good documentary about healthy eating the plant based diet called Forks Over Knives on Netflix. We are living it and like it.

    Reply
    • There must be a connection. My daughter had the surgery last April when she was 10 years old. She had pretty bad sleep apnea and frequent throat infections, enlarged tonsils. She had always been a peanut, in the 30th % for both height and weight. At the time of surgery she wore a size childrens 7/8 slim jeans. One year later she wears a junior/womens size 1/2 jeans and a size 7 1/2 womens shoe, larger than mine. She wears my clothes! She has gone through puberty, has just started her period and is the only girl in her class to do so. It has been awful for her and shocking for us as parents. She is only 11! She outgrew all of her clothes and skipped the rest of the kid sizes. I am not sure I would have made the choice to have the surgery now had I known this could happen, or I would have insisted on hormone blockers. This also happened to a neighbors daughter who is on the same cheer team, but I just found out now that she had her tonsils out. She is the same age. Think twice, parents!

      Reply
  6. I was actually just speaking with my therapist the other day about what could have been the cause of my weight gain as a child. Prior to my adenotonsillectomy at age 9, I was a very normal weight. I realize that I didn’t fall under the category most at risk (age 6 and below). However, after the surgery, my weight steadily increased for no explainable reason. I struggled with weight management throughout the rest of my adolescence and into early adulthood.

    Clearly, I take responsibility for the majority of my weight gain since that time due to low activity levels and overconsumption of unhealthy foods. However, this potentially explains the onset of physiological changes that occurred immediately following this surgery.

    Reply
  7. My daughter is 25. She had her tonsils out when she was 4.5. By the time she started kindergarten 8 months later, she had DOUBLED her weight. She has continued to gain weight well into adulthood. I have been convinced for 20 years that her tonsillectomy and adenoid removal had something to do with her weight gain, but it makes me sound crazy.

    Reply
    • My son did the same thing as did 12 other children I know

      Reply
    • I had my tonsils and adanoids removed at age 7, I was very skinny, by age 10 I was obese and it didn’t hit me until
      I got teased. I have since found it very hard to lose weight beyond a body fat of 25% with controlled calories and exercise. I am now 31 and still obese. It took many years for my mother to believe me about this link between the operation and my size, whereas my father branded me a lazy overeater. If you do put your kids through this then make sure you actively monitor their activity levels and food intake and weight gain.

      Reply
    • The same sort of thing happened to mine. She probably gain 40 lbs + in the year following her surgery and it’s been constant struggle. She even looks at food and she puts lbs on. Strangely, the same thing happened to me as a child and that was 50 yrs ago. I’ve told all the doctors over the yrs there was a correlation but they pretty much dismissed my concern

      Reply
  8. I would like to know what supplement you used. My daughter had her tonsils removed at age 5. She was fairly thin and soon after the surgery she began to gain weight. She is now age 9 and close to being obese on the charts. Please let me know what supplement you used. Thanks!

    Reply
  9. I wonder if there is a correlation between the reason for the surgery and the weight gain. My very thin daughter had obstructive apnea, which was the reason for the surgery. She is still a fairly healthy weight, but definitely gained weight somewhat rapidly. I have wondered if it was related to the decreased oxygen they were getting beforehand, as opposed to kids who have them removed because of frequent infections and not apnea. Maybe getting full oxygen after having apnea for years changes the metabolism.

    Reply
  10. Trisha I found this website due to people saying my sons weight gain was due to tonsils getting taken out hearing about ur grandson is so sad I know how hard these boys want to be thinner my son to plays sports eats healthy and can not loose anything please do tell if you hear anything 🙁

    Reply
    • My son was also one of those children who gained weight after having his tonsils & adenoids removed at age 8 he is now 16. He went from a thin child to obese very rapidly .There was no change in his diet or eating habits, he was / is a very hyper active kid doesnt sit still for long otherwise he may have gained more weight i really dont know. I watched my witty funny out going child diminish year after year because the weight gain was taking a toll on his personality, kids at school say things, even though he is a kid that always stood up for himself words stick and hurt.he developed anxiety & depression to the point i had to pull him out of school & do virtual home schooling for almost 2 years. I then found some all 100% natural supplements that help your body get healthy and also helps with weight loss ,i started him on these products about 6 months ago.He has lost over 30 lbs he has gained alot of his confidence back and is back in public school doing well. i never told him he needed to lose weight i never mentioned it to him i was perfectly happy with him being just the way he was but he wasnt & it broke my heart . I dont want to put the name of the supplements on here like im trying to sell a product . But if anyone would like to know just ask.

      Reply
      • I would love to know the supplements that you used. My son has been gaining weight steadily since his surgery. It feels like nothing we have tried helps. Thank you.

        Reply
        • I would like to know if momof2 has sent you the supplements that she used with her child. If so please let me know. I’ve asked but it has been a year since this was posted so I think I was to late to get an answer. Any help you can give me will be greatly appreciated.
          God blesss

          Reply
      • I want to know the supplements you used. My daughter is now 8 and has gained weight like crazy since having her adenoids removed.

        Reply
      • I would also like to know the supplements. My daughter has experienced the weight gain.

        Reply
      • I would like to know the supplements you used.

        Reply
      • I am a 16 year old and I had my tonsils out when I was 6 and have been battling unexplained weight gain ever since even though I was actually very skinny before the operation. I never changed my diet from before the operation to after. I have been to 23 doctors and they’ve never been able to find anything, I always come out crying because they just think I eat rubbish. Could I please have the name of these supplements?

        Thank you!

        Reply
      • Yes, my 6 year old granddaughter had her tonsils out when she was 3. She could only get 10% oxygen! Really bad!! Within two months of surgery her weight doubled. We have watched her diet and she still is a very picky eater. Yet, the weight keeps coming. Please let me know what this supplement is and with her Drs approval will give it a try. The Dr. and all of us are desperate for answers.

        Reply
      • Hi. Both of my sons rapidly gained weight after their surgeries. Within a month they’ve gained so much that it put them into the overweight/obese territory of the BMI charts. Their diets have not changed at all, and were quite healthy with occasional treats (no soda ever, no junk). Their activity levels have not changed either. I feel like the worst parent, and really don’t know what to do. Please share the name of the supplement (on or off-line), so I may try and look into that. If not now, then when my kids are a bit older. Thank you.

        Reply
        • Please can you tell me what the supplement is as my granddaughter had her tonsils removed when she was 5 and has gained so much weight she is 9 and has to wear adult clothes

          Reply
      • What’s the name

        Reply
      • Yes, please! I could use any information to help my daughter! Thank you!

        Reply
      • would also like to know about the supplements
        I was one of those kids that this happened to
        skinny/underweight before..obese after…then watched the same thing happen to my niece who is morbidly obese…

        Reply
      • hi, my daughter has same issue. she is 7 yrs old and seems like she gaining weight even she watch her diet and exercise. could you tell me about that product ,and its safe for kids ? I would like to know about it. please thanks.

        Reply
      • what supplements did you use as my son is also rapidly gaining weight after removing his tonsils. Thanks!

        Reply
      • What we’re the supplements?

        Reply
      • Can I please know the what you gave your child to help get him healthy. My son is almost 18 and has struggled since he was 3. We have tried everything. Nothing helps

        Reply
      • What’s the supplements please ?

        Reply
      • I would love to know the name of the supplements. My son, too, had his adenoids and tonsils out at the age of 2.5. Within 6 months he grew over 30%, and at 11 is considered obese.

        Reply
      • Please advise supplement. My grandson has put on an extreme amount of weight since his tonsils were removed only 4 months ago.

        Reply
      • I would be very interested to know what these supplements are. I had my tonsils out before or around my 6th birthday and ballooned after that, suffering teasing and name calling which resulted in suicidal thoughts by age 14 and a loss of self esteem I have never totally regained. Thank you

        Reply
      • i would love to know the name of the supplements. My son has his tonsils removed when he was 5 because of breathing difficulties and sleep apnea. He was always super active and ate well. After he had his tonsils removed he rapidly put on weight despite having a healthy diet and being active including squad swimming 4 times a week. I have always suspected that it had to do with his tonsils. He is now 13 and continues to participate in as many sports as possible but I know that he feels very disheartened because of his size. It would be amazing to understand why weight gain is linked to tonsils being removed in young children. Once this is understood perhaps it could be prevented.

        Reply
      • My child had the same procedure when she was small and underweight at age 5. Happy and outgoing. Now she is 42 and continues to gain weight. She is outgoing and well adjusted but continues a daily battle to lose and keep off weight. We would very much appreciate the name of the supplement. My request is for her and for the sake of her child.

        Reply
      • I would very much like to know what the supplement was, as my son had the procedure less than 2 months ago and has gained a lot of weight in a very short amount of time. I would like to be ahead of anything that can help him in the future if I can. Thank you

        Reply
      • Please give me the name of the supplement! My 10 year old’s weight has almost tripled since having surgery at age 7. He is extremely active in all extra curricular sports in school and plays hockey 3-4 times weekly. Please help!

        Reply
      • Please share what the supplements you’re referring to. It happened to someone in my family and I would like to help them. It seems helpless at times.

        Reply
      • Please tell the supplements. So many have asked. We are desperate. If not a name can you point us to a website? Feeling bad for my son 🙁

        Reply
      • The same thing has happened 2 my daughter it’s 2 the point where I’m worried about her weight could I please tell me what supplement u used plz

        Reply
      • What’s this supplement you are talking about? My daughter gained weight after the surgery. I would like to give it a try with her.

        Reply
      • I just turned 69 years old and back in the day (50’s) they didn’t know about the weight gain I would like to know the supplements to see if they would help me. Been way overweight all my life. Thanks for any help you can suggest…. Barbara

        Reply
      • Please let me know the supplement name.

        Reply
      • Please give me the supplement name ?
        Thank you
        To loose weight or stay healthy after tonsillectomy

        Reply
      • What was the supplement? Please!!

        Reply
      • I am very curious what supplements.
        My daughter had her T & A out 3 years ago right before she turned 5, now she is 8 & has gained a dramatic amount of weight since – I never connected the dots. Although she didn’t start gaining a lot right away. My daughter had Severe OSA & has Down syndrome so some consider it “normal” to be heavier. That drives me crazy

        Reply
      • I would like to know. If you don’t want to “sell” the product then send me a private message. I feel desperate in this.

        Reply
  11. I really hope the researchers continue their studies. I am one of those children who had their tonsils and adenoids removed in Kindergarten and proceeded to steadily gain weight afterwards. By second grade I was off the pediatric growth charts. Now, at 30 years of age I am considered morbidly obese weighing in at 417 pounds currently. My highest weight was 472 pounds. While I know it is past too late for me because the damage has already been done physically and emotionally, I hope that other children can avoid this predicament entirely. Thanks for listening. God bless!

    Reply
    • Nothing has changed. My grandson had sleep apnea. Removed tonsils & adenoids and a month after surgery begin gaining weight . One month gained 20 pounds and immediately called dr. and all is dismissed to diet and exercise. After 4 years nothing has changed in weight gain area. He plays football and that has a playing season from August – January . That did not stop or change any weight issues. We are still looking for answers !. Setting up appt with pediatric enchronologist. This is a very REAL issue. This destroys children lives. If anyone has any answers to this issue please let me know. I will do the same.!! My grandson is in 6th grade now and he would like his body back !!!!!!!! there has to be a reason and an answer.!!!!!!

      Reply
      • I had both tonsils and adenoids removed at age 7. Prior to the surgery, I
        was very tiny. Within weeks of the surgery, I had gained enough weight
        that my dad was able to notice.
        Today, as a 50-plus adult, I have had to fight my weight every day. This
        despite the fact that I consume less food than most of my friends and
        family and despite trying to stay active.
        I’ve always believed that my weight problems started when I had my
        tonsils & adenoids out and wish that someone would actually look into
        this. I’d even volunteer to be studied if I could get answers.

        Reply

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