Bariatric Surgery in Adolescence. Is this the Best Age to Operate?

Capella, Joseph F.; Capella, Rafael F.

doi:10.1381/096089203322618597

Cited by 92 publications

(56 citation statements)

References 17 publications

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“…220 Five articles over the past decade reported intermediate-to longterm outcomes of various operations including RYGB, [221][222][223][224][225] whereas fewer reported only RYGB outcomes. .…”

Section: Roux En Y Gastric Bypassmentioning

confidence: 99%

Severe Obesity in Children and Adolescents: Identification, Associated Health Risks, and Treatment Approaches

Kelly¹,

Barlow

Rao³

et al. 2013

Circulation

881

804

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espite recent data suggesting that the rate of increase of obesity among children and adolescents has slowed and overall prevalence has possibly begun to plateau, 1,2 a worrisome trend has emerged in the form of severe pediatric obesity. As the fastest-growing subcategory of obesity in children and adolescents, 1,3,4 severe obesity afflicts between 4% and 6% of all youth in the United States 3-7 and has both immediate and long-term health consequences. Recent data further Abstract-Severe obesity afflicts between 4% and 6% of all youth in the United States, and the prevalence is increasing.Despite the serious immediate and long-term cardiovascular, metabolic, and other health consequences of severe pediatric obesity, current treatments are limited in effectiveness and lack widespread availability. Lifestyle modification/behaviorbased treatment interventions in youth with severe obesity have demonstrated modest improvement in body mass index status, but participants have generally remained severely obese and often regained weight after the conclusion of the treatment programs. The role of medical management is minimal, because only 1 medication is currently approved for the treatment of obesity in adolescents. Bariatric surgery has generally been effective in reducing body mass index and improving cardiovascular and metabolic risk factors; however, reports of long-term outcomes are few, many youth with severe obesity do not qualify for surgery, and access is limited by lack of insurance coverage. To begin to address these challenges, the purposes of this scientific statement are to (1) provide justification for and recommend a standardized definition of severe obesity in children and adolescents; (2) raise awareness of this serious and growing problem by summarizing the current literature in this area in terms of the epidemiology and trends, associated health risks (immediate and long-term), and challenges and shortcomings of currently available treatment options; and (3) highlight areas in need of future research. Innovative behavior-based treatment, minimally invasive procedures, and medications currently under development all need to be evaluated for their efficacy and safety in this group of patients with high medical and psychosocial risks. (Circulation. 2013;128:1689-1712.)

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Section: Roux En Y Gastric Bypassmentioning

confidence: 99%

Severe Obesity in Children and Adolescents: Identification, Associated Health Risks, and Treatment Approaches

Kelly¹,

Barlow

Rao³

et al. 2013

Circulation

881

804

View full text Add to dashboard Cite

show abstract

“…[1][2][3][4] This paradigm shift has occurred in part because of the realization that nonsurgical approaches are of limited effectiveness for severe obesity (body mass index, calculated as weight in kilograms divided by height in meters squared, Ն40) in children 5 and in part because of the documented health benefits of bariatric surgery in adults. 6,7 On the basis of these factors, a number of pediatric groups have suggested that bariatric surgery is an appropriate treatment for carefully selected morbidly obese adolescents with severe comorbidities.…”

Section: Arch Pediatr Adolesc Med 2007;161:217-221mentioning

confidence: 99%

Bariatric Surgery in Adolescents

Tsai¹,

Inge²,

Burd³

2007

Arch Pediatr Adolesc Med

203

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“…What is known is that these youth are at a significantly heightened risk for developing obesity-related medical comorbidities 12 and, not surprisingly, report some of the most severe and global (eg, physical, social, emotional) impairments in quality of life relative to that reported in the broader pediatric literature. 13 Given the likelihood that extremely obese adolescents will remain extremely obese as adults, 12,14 increasing focus has been placed on understanding the medical and psychosocial burden of this growing subpopulation.…”

mentioning

confidence: 99%

Risk-Taking Behaviors of Adolescents With Extreme Obesity: Normative or Not?

et al. 2011

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OBJECTIVE: Present first published data detailing high-risk behaviors of adolescent high school students (HSS) with extreme obesity (BMI ≥ 99th percentile for age and gender) compared with healthy weight peers (5th–84th percentile). METHODS: The 2007 Youth Risk Behavior Survey was used to compare HSS with extreme obesity (N = 410) and healthy weight peers (N = 8669) in their engagement in (1) tobacco use, (2) alcohol/other drug use, (3) high-risk sexual behaviors, and (4) suicidal behaviors. Logistic regression was used to calculate gender-stratified odds ratios (OR) and 95% confidence intervals (CI), controlling for age and race. RESULTS: HSS with extreme obesity were similar to healthy weight peers in the prevalence of most behaviors related to alcohol/drug use, high-risk sexual activities, and suicide, with the following exceptions: relative to healthy weight HSS, both male and female students with extreme obesity more frequently reported ever trying cigarettes (female students, adjusted OR: 2.0 [95% CI: 1.3–3.2]; male students, OR: 1.5 [CI: 1.2–2.0]). Compared with healthy weight female students, female students with extreme obesity had lower odds of ever having sex (OR: 0.5 [CI: 0.3–0.9]), but greater odds of drinking alcohol/using drugs before their last sexual encounter (OR: 4.6 [CI: 1.2–17.6]), currently smoking (OR: 2.3 [CI: 1.2–4.4]), and using smokeless tobacco (OR: 4.6 [CI: 1.2–17.2]). Compared with healthy weight male students, male students with extreme obesity had greater odds of smoking before age 13 (OR: 1.4 [CI: 1.0–2.0]). CONCLUSIONS: With few exceptions, HSS with extreme obesity engage in high-risk behaviors at rates comparable with healthy weight peers, sometimes in even more dangerous ways. Health care providers should assess risk-taking behaviors in this cohort.

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Bariatric Surgery in Adolescence. Is this the Best Age to Operate?

Abstract: Early surgical intervention should be offered to a greater number of adolescents to minimize the emotional and physical consequences of morbid obesity.

Cited by 92 publications

References 17 publications

Severe Obesity in Children and Adolescents: Identification, Associated Health Risks, and Treatment Approaches

Severe Obesity in Children and Adolescents: Identification, Associated Health Risks, and Treatment Approaches

Bariatric Surgery in Adolescents

Risk-Taking Behaviors of Adolescents With Extreme Obesity: Normative or Not?

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