Recent National Trends in the Use of Adolescent Inpatient Bariatric Surgery

Abstract

Participants: Adolescents (defined herein as individuals aged 10-19 years) undergoing inpatient bariatric procedures.

Bariatric Surgery in Youth

“…A cross-sectional study looking at national surgical trends in obese adolescent patients found that RYGB was the most commonly performed weight reduction procedure for patients between 10 and 19 years of age in the United States, with RYGB comprising 67.6% of all interventions performed on this population. 63 Much like in adults, excellent results have been reported for adolescents undergoing RYGB with 35% reduction in weight seen at 1 year after surgery. 64 A meta-analysis of all bariatric surgery in pediatric patients reported decreases in BMI of 17.8 to 22.3 units.…”

“…Despite lack of FDA approval of the AGB for patients younger than 18 years, there had been a surge of AGBs implanted into adolescent patients in recent years with AGB insertions comprising almost one-third of all bariatric procedures performed in 2009 (approval for implantation was granted through investigational device exemption from the FDA). 63 Although initially thought to have an excellent safety profile with substantial loss of excess body weight (37%-63%) achieved during a 6-month to 7-year follow-up period, 70 reoperation rates of 8% to 10% for mechanical device failure, band slippage, band erosion, or band removal limited their use. 65 Although implantation of AGBs results in greater weight loss and improvement in quality of life indices and health status compared with nonoperative weight reduction approaches, there has been a drastic decline in the numbers of AGB devices implanted in pediatric patients in the United States today.…”

Ethical considerations in the treatment of childhood obesity

“…41,42 Commonalities in these findings lie in the demographics, with a larger number of patients being female, privately insured, with an average age of 16 years, predominantly Caucasian, from high-income families. However, Medicaid use for these types of surgeries has increased from 7.7% in 2003 to 17.2% in 2009.…”

“…However, Medicaid use for these types of surgeries has increased from 7.7% in 2003 to 17.2% in 2009. 41 Also, while some researchers found adolescent patients were more likely to receive bypass surgery, [41][42][43] one recent California study found gastric banding had increased, while bypass procedures had decreased. 44 Others report sleeve surgeries are becoming more readily selected 45 and have been performed on children as young as 7 years old.…”

Comment on: Predictors and Outcomes of adolescent bariatric support group attendance

“…In addition to the exponential rise in obesity, a mounting body of evidence has shown a parallel increase in the prevalence of obesity-related co-morbid diseases (e.g., type 2 diabetes mellitus, insulin resistance, hypertension, hyperlipidemia, obstructive sleep apnea, liver disease) in the extremely obese adolescent population [3][4][5][6][7][8][9][10]. The combination of these observations, coupled with increasing evidence that obese children have a high propensity of becoming correspondingly obese adults [2], has recently resulted in a steady increase in the utilization of bariatric surgery in the pediatric age group [11,12].…”