Partnering Support Interventions with Bariatric Surgery to Maximize Health Outcomes in Adolescents with Severe Obesity

Abstract

Objective Rates of adolescents with severe obesity continue to rise worldwide, with concurrent increases in metabolic and bariatric surgery (MBS) uptake. The gap between support (lifestyle, pharmacotherapy) interventions and MBS as treatment options for adolescents has been understudied. This review, couched in a socio‐ecological framework, investigates how support interventions for adolescents with severe obesity could be combined or sequenced with MBS to optimize health outcomes. Methods A comprehensive search revealed 36 published articles between 1995 and 2019 that included the combination of support interventions and MBS among adolescents. Results There were no studies that specifically reported outcomes or effect sizes for the combination of lifestyle intervention with MBS. Previous studies have reported individual results for either lifestyle intervention or MBS but not for their compound effect. Conclusions As rates of adolescents with severe obesity are on the rise globally, future research should focus on how partnering support interventions with MBS can amplify positive short‐ and long‐term health outcomes and within a socio‐ecological framework. Understanding the sequence of these approaches will be of particular importance. High‐risk and vulnerable populations such as ethnic minorities who have suffered a disproportionate burden of the obesity epidemic must be included in rigorously tested future trials of combination interventions to maximize health outcomes worldwide.

Adaptation of a standardized lifestyle intervention to maximize health outcomes in adolescent metabolic and bariatric surgery patients

“…Our study ow is adapted from the Obesity-Related Behavioral Intervention Trials (ORBIT, Fig. 2) 17 systematic framework that focuses on the proof-of-concept phase of intervention development. ORBIT is used to guide efforts to translate basic behavioral science ndings into behavioral treatments for preventing and treating chronic illness.…”

“…17 and/or (c) Refuses to participate in the study. 17 Participants. A total of 19 participants (76% females, 59% Hispanic/Latino, 42% non-Hispanic Black, mean age 15.2 years) preparing for MBS were recruited from the Children's Health System of Texas in Dallas MBS clinic.…”

“…"TeenLYFT" 17 is an ongoing study conducted at Children's Health System of Texas. It has three aims described in Fig.…”

“…Moreover, only one study included a theoretical framework with key, testable constructs to support the combination of lifestyle and MBS interventions. 11 In a second systematic review examining the use of digital platforms to deliver behavioral lifestyle interventions to MBS patients, 12 results showed that studies varied widely in design (qualitative to randomized controlled trials) and eHealth delivery method (telemedicine to blog post content) for pre-or post-MBS use. Further, no studies included adolescents, and very few reported (1) a conceptual framework to support study design/outcomes; and (2) race/ethnicity composition of participants.…”

“…elevated blood pressure, hypercholesterolemia, etc.] or a BMI > 40kg/m 2 ) and (c) Consents/assents to participate in the study 17. Conversely, exclusion criteria included the following; (a) Does not meet National Institutes of Health (BMI > 35 kg/m 2 and at least one existing co-morbidity [e.g.…”