Barriers to metabolic bariatric surgery in adolescents: results of a qualitative study

What matters to adolescents with obesity, and their caregivers, when considering bariatric surgery or weight loss devices? A qualitative evidence synthesis

“…26,31 In two other studies, adolescents reported that it was better to have surgery when older, when greater maturity facilitated an individual's ability to cope with the demands of the procedure. 24,27 In one further study, participants expressed a similar hesitancy about having surgery too young. 23 Finally, in three additional studies, participants reported that they originally thought surgery offered a "quick solution" but were made to wait and ultimately agreed with that decision.…”

“…29 The age at procedure (or the age at interview for participants who had not had a procedure) ranged from 13 to 18 years in 12 studies, 32,39 from 14 to 21 years in one study, 25 from 16 to 24 years in one study, 35 and from 18 up to 28 years in three studies. 24,37,41 Therefore, no study included children under 13 years. Nine studies included populations from North America (Canada n = 4, USA n = 5),…”

“…24,25,38 However, this recognition was qualified by some adolescents in two of the studies: in one study, it was reported that while some adolescents might perceive themselves as living with overweight or obesity, other people, including health professionals and family, did not consider this condition to be "severe." 24 In another study, the participants themselves reported a distinction between living with obesity and being "super obese" and therefore a candidate for surgery. 38 This distinction was further reflected in another study, in which adolescents considered themselves to be living with obesity but not having "severe" obesity.…”

“…Adolescents and family members in six studies reported that they perceived surgery as a last resort; the only option left when all of the alternatives had been tried, without success. 24,[25][26][27]33,38,42 In one study, lack of time to be able to adhere fully to alternatives was cited as one of the problems, 25 while in another adolescents noted that parents should have supported all the alternatives first too, before surgery was considered as an option. 27…”

Adolescents with Type 2 Diabetes: Overcoming Barriers to Effective Weight Management

“…These include a stigma around MBS as treatment for obesity, lack of access due to insurance coverage, lack of awareness amongst physicians about the benefits of MBS and family concerns about a surgical procedure during adolescence. 151 Additionally, despite higher prevalence of obesity and T2DM in ethnic minorities, white adolescents undergo MBS more frequently than Blacks (2.5 times higher) and Hispanics (2.3 times). Almost two thirds of adolescent bariatric surgeries in the Bariatric Outcomes Longitudinal Database, a national database that collects bariatric surgical care data in the United States were performed in White youth.…”