Bariatric Surgery in Adolescents: To Do or Not to Do?

Abstract

Pediatric obesity is a multifaceted disease that can impact physical and mental health. It is a complex condition that interweaves biological, developmental, environmental, behavioral, and genetic factors. In most cases lifestyle and behavioral modification as well as medical treatment led to poor short-term weight reduction and long-term failure. Thus, bariatric surgery should be considered in adolescents with moderate to severe obesity who have previously participated in lifestyle interventions with unsuccessful outcomes. In particular, laparoscopic sleeve gastrectomy is considered the most commonly performed bariatric surgery worldwide. The procedure is safe and feasible. The efficacy of this weight loss surgical procedure has been demonstrated in pediatric age. Nevertheless, there are barriers at the patient, provider, and health system levels, to be removed. First and foremost, more efforts must be made to prevent decline in nutritional status that is frequent after bariatric surgery, and to avoid inadequate weight loss and weight regain, ensuring successful long-term treatment and allowing healthy growth. In this narrative review, we considered the rationale behind surgical treatment options, outcomes, and clinical indications in adolescents with severe obesity, focusing on LSG, nutritional management, and resolution of metabolic comorbidities.

Benefits of Physical Exercise as Approach to Prevention and Reversion of Non-Alcoholic Fatty Liver Disease in Children and Adolescents with Obesity

“…Prevention remains the best approach to face the burden of this condition. Lifestyle interventions are feasible and effective in both the prevention and treatment of childhood obesity, and pharmacological and surgical treatment are available for a selected population of children and adolescents with obesity [ 17 , 18 , 22 , 23 , 24 ].…”

Safety and efficacy of roux-en-y gastric bypass in older aged patients

“…However, the reproducibility of safety and efficacy of this intervention in the extremes of age has been controversial [3][4][5] . In older, frail individuals, the perioperative and short-term safety of the intervention has been called into question; while in adolescent and younger individuals, the long-term metabolic and developmental effects are often cited as areas of concern and not well understood [6][7][8][9] .…”

Dermatological manifestations relating to nutritional deficiencies after bariatric surgery: case report and integrative literature review

“…However, it was also a sad reminder of patients’ and their parents’ expectations and the ethics regarding bariatric surgery in the pediatric population; issues that will not be tackled here. 12 …”