7th Annual Association for Bariatric Endoscopy (ABE) Meeting: Comprehensive Care of the Patient with Obesity – Endoscopy and Beyond! | May 2022-Adolescence Obesity: What Do We Do for the Youth?

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This document discusses the growing dilemma of bariatric surgery in adolescent patients who are severely obese. It highlights the risks and comorbidities associated with adolescent obesity, including obstructive sleep apnea, diabetes, hypertension, cardiac hypertrophy, and nonalcoholic fatty liver disease. The psychosocial consequences of adolescent obesity are also discussed, such as higher rates of depression, ADHD, bullying, and decreased education completion. Intensive lifestyle modification and behavioral therapies are found to have limited value in sustained weight loss. The history of adolescent bariatric surgery is reviewed, with an increase in procedures in the 1990s and early 2000s. The criteria for patient selection in adolescent bariatric surgery are outlined, including BMI classification, sustained weight loss efforts, physical maturity, and ability to adhere to postoperative regimens. The document also discusses controversies and concerns surrounding adolescent bariatric surgery, including immediate risk, long-term complications, nutrition, growth and development, compliance, efficacy, and ethical considerations. The limited research available on adolescent bariatric surgery is presented, including a randomized controlled trial that showed improved outcomes with surgery compared to a lifestyle program. The outcomes of weight change and comorbidity remission are presented, as well as complications and reoperations. The establishment of adolescent bariatric surgery programs is discussed, including the need for a multidisciplinary team, governance structure, and standardized clinical pathways. Finally, remaining questions in the field are presented, such as the long-term effects of surgery, appropriate age for surgery, use of newer surgical and endoscopic procedures, and the placement of foreign bodies.

Asset Subtitle

Aurora Pryor, MD

Keywords

bariatric surgery

adolescent obesity

comorbidities

psychosocial consequences

lifestyle modification

patient selection

controversies

outcomes

adolescent bariatric surgery programs

remaining questions