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Bariatric surgery for severely obese adolescents
Harvey J Sugerman1, Elizabeth L Sugerman2, Eric J DeMaria2
1Division of General Surgery, Department of Surgery, Virginia Commonwealth University, Richmond, Virginia. hsugerma@hsc.vcu.edu.
Summary
Bariatric surgery is safe for severely obese adolescents, leading to significant weight loss and improved health outcomes. This study supports surgical intervention for adolescents facing obesity-related comorbidities and social challenges.
Area of Science:
- Pediatric Surgery
- Obesity Medicine
- Adolescent Health
Background:
- Adolescent obesity rates have doubled over 30 years, with limited data on surgical interventions.
- The 1991 National Institutes of Health Consensus Conference deemed bariatric surgery for adults but not adolescents due to insufficient data.
Purpose of the Study:
- To review a 20-year database of bariatric surgery outcomes in severely obese adolescents.
- To evaluate the safety, efficacy, and long-term results of bariatric surgery in this population.
Main Methods:
- A retrospective review of 33 adolescents (12-17 years) who underwent bariatric surgery between 1981 and 2001.
- Procedures included gastroplasty, gastric bypass (standard, D-GBP, LL-GBP), with laparoscopic approaches used after 2000.
- Data collected on BMI, comorbidities, surgical complications, weight loss, and long-term outcomes.
Main Results:
- Mean BMI was 52 +/- 11 kg/m(2); common preoperative comorbidities included hypertension, sleep apnea, and degenerative joint disease.
- No operative deaths or anastomotic leaks occurred; early and late complications were manageable.
- Significant weight loss was maintained long-term (up to 14 years) in most patients, with resolution of most comorbidities and improved self-image.
Conclusions:
- Bariatric surgery is a safe and effective option for severely obese adolescents, addressing significant comorbidities and improving quality of life.
- The findings support the consideration of bariatric surgery for adolescents with severe obesity, challenging previous limitations based on adult criteria.