An Examination of Pre/Post-Adenotonsillectomy Obesity Indices in 3-10 Year Old Children in Mashad, Iran

Document Type : Original


1 Biochemistry and Nutrition Research Center and Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 3Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

4 4Department of otorhinolaryngology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

5 Ear, Nose, Throat, Head and Neck surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran


Adenotonsillectomy is one of the most frequent surgical operations on children, which may result in weight gain in a number ways, for instance, by increasing IGF-1 or decreasing respiratory hyperactivity.
Materials and Methods:
This was an intervention study with a control group, conducted on fifty 3-10-year-old children who had undergone adenotonsillectomy and on fifty children as the control group. The intervention and control groups were identical in terms of age and sex. Height, weight, mid-arm muscle circumference, waist circumference, and percent body fat measures were performed on the intervention group before and six months after the surgery. The same measurements were also performed on the control group at zero time and six months later. Ultimately, the results were examined and compared.
The body mass index (BMI) and percent body fat in the intervention group showed a significant change after six months, with P values of 0.002 and 0.024 respectively. There were no significant correlations for other variables.
Based on the findings of this study, children who had undergone adenotonsillectomy for various indications showed a gradual postoperative increase in their BMI and percent body fat.


  1. James PT, Leach R, Kalamara E, Shayeghi M. The worldwide obesity epidemic. Obesity 2001; 9: 228-33.
  2. Wilson PWF, D'Agostino RB, Sullivan L, Parise H, Kannel WB. Overweight and obesity as determinants of cardiovascular risk: The Framingham experience. Arch Int Med 2002; 162(16): 1867-72.
  3. Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. New England J Med 2001; 344(18): 1343-50.
  4. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England J Med 2002; 346(6): 393-403.
  5. Bjerkedal T. Overweight and hypertension. Acta Medica Scand 1957; 159(1): 13-26.
  6. Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of US adults. New England J Med 2003; 348(17):1625-38.
  7. Flegal KM, Graubard BI, Williamson DF, Gail MH. Excess deaths associated with underweight, overweight, and obesity. JAMA 2005; 293(15): 1861-7.
  8. Strauss RS, Pollack HA. Epidemic increase in childhood overweight. JAMA 2001; 286(22): 2845-8.
  9. Hedley AA, Ogden CL, Johnson CL, Carroll MD, Curtin LR, Flegal KM. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999-2002. JAMA 2004; 291: 2350-847.
  10. WHO. Childhood overweight and obesity. [cited 2010 Sep 11]. Available from: URL;
  11. WHO. Obesity and overweight. [cited 2010 Sep 11]. Available from: URL;
  12. Van Staaij BK, Van Den Akker EH, Rovers MM, Hordijk GJ, Hoes AW, Schilder AGM. Effectiveness of adenotonsillectomy in children with mild symptoms of throat infections or adenotonsillar hypertrophy: Open, randomised controlled trial. BMJ 2004; 329(7467): 651.
  13. Roemmich JN, Barkley JE, D'Andrea L, Nikova M, Rogol AD, Carskadon MA, 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(2): 200-8.
  14. Paradise JL, Bluestone CD, Colborn DK, Bernard BS, Rockette HE, Kurs-Lasky M. Tonsillectomy and adenotonsillectomy for recurrent throat infection in moderately affected children. Pediatrics 2002; 110(1): 7-15.
  15. Hammond K. Krause's food and nutrition therapy. Assessment, dietary and clinical data. 12th ed. 2008.
  16. Camilleri AE, McKenzie K, Gatehouse S. The effect of recurrent tonsillitis and tonsillectomy on growth in childhood. Clin Otolaryngol Alli Sci 1995; 20(2): 153-7.
  17. Wijga AH, Scholtens S, Wieringa MH, Kerkhof M, Gerritsen J, Brunekreef B, et al. Adenotonsillectomy and the development of overweight. Pediatrics 2009; 123(4): 1095-101.
  18. Nieminen P, Lopponen T, Tolonen U, Lanning P, Knip M, Lopponen H. Growth and biochemical markers of growth in children with snoring and obstructive sleep apnea. Pediatrics 2002; 109(4): 55.
  19. Soultan Z, Wadowski S, Rao M, Kravath RE. Effect of treating obstructive sleep apnea by tonsillectomy and/or adenoidectomy on obesity in children. Arch Pediatr Adolesc Med 1999; 153(1): 33-7.
  20. Williams EF, Woo P, Miller R, Kellman RM. The effects of adenotonsillectomy on growth in young children. Otolaryngol Head Neck Surg 1991; 104(4): 509-16.
  21. Bar A, Tarasiuk A, Segev Y, Phillip M, Tal A. The effect of adenotonsillectomy on serum insulin-like growth factor-I and growth in children with obstructive sleep apnea syndrome. Pediatrics 1999; 135(1): 76-80.
  22. Ylmaz MD, Ho Al AS, Uz O, Yordam N, Kaya S. The effects of tonsillectomy and adenoidectomy on serum IGF I and IGFBP3 levels in children. Laryngoscope 2002; 112(5): 922-5.
  23. Selimoglu E, Selimoglu MA, Orbak Z. Does adenotonsillectomy improve growth in children with obstructive adenotonsillar hypertrophy? J Int Med Res 2003; 31(2): 84-7.
  24. Tal A, Bar A, Leiberman A, Tarasiuk A. Sleep characteristics following adenotonsillectomy in children with obstructive sleep apnea syndrome. Chest 2003; 124: 948-53.
  25. Marcus CL, Carroll JL, Koerner CB, Hamer A, Lutz J, Loughlin GM. Determinants of growth in children with the obstructive sleep apnea syndrome. Pediatrics 1994; 125(4): 556-62.
  26. Mitchell RB, Kelly J. Adenotonsillectomy for obstructive sleep apnea in obese children. Otolaryngol Head Neck Surg 2004; 131(1): 104-8.