February 8, 2006

Some kids gain weight after adenotonsillectomy

By Will Boggs, MD

NEW YORK (Reuters Health) - After having their tonsils and
adenoids out because of obstructed breathing during sleep, some
children tend to become overweight. The reason may be a
decrease in fidgeting and hyperactivity, according to a new

Children "should be closely monitored" for changes in their
weight after undergoing adenotonsillectomy, Dr. James N.
Roemmich told Reuters Health, and "physicians should provide
appropriate counseling regarding weight control behaviors for
children and their parents."

Roemmich, from the State University of New York at Buffalo,
and colleagues investigated the effects of the operation on
weight gain, activity, and hyperactivity in 54 children with
obstructive sleep-disordered breathing.

Sleep time did not change after surgery, the authors report
in the medical journal Pediatrics, but the number of brief
breathing stoppages during sleep fell from an average of more
than seven episodes per hour to less than one.

Body weight increased significantly after surgery, the
report indicates, resulting in significant increases in body
mass index -- a measure of weight in relation to height -- and
the percentage of the children who were overweight.

Activity counts decreased significantly after
adenotonsillectomy, the researchers found, and parents reported
significantly lower ratings of child hyperactivity. After
controlling for initial hyperactivity, these were reflective of
weight changes.

A possible reason for the reduction in activity scores,
Roemmich said, is "better sleep quality after
adenotonsillectomy." This might result in "lower irritability
and reduced hyperactivity of the children during the day so
that they fidget less when awake."

Another factor in the tendency to gain weight, he added,
"could be a reduction in the energy cost of breathing."

SOURCE: Pediatrics, February 2006.