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Multidisciplinary Approach to Obesity Management: A Case Report
Published on: May 30, 2025
Best practice updates for pediatric/adolescent weight loss surgery.
Janey S A Pratt1, Carine M Lenders, Emily A Dionne
1Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA. jpratt@partners.org
Obesity (Silver Spring, Md.)
|April 28, 2009
Summary
Updated guidelines recommend expanding weight loss surgery (WLS) criteria for adolescents with obesity and comorbidities. This includes those with BMI >or= 35 and specific health issues, or BMI >or= 40 for long-term risk management.
Area of Science:
- Pediatric Surgery
- Bariatric Surgery
- Evidence-Based Medicine
Background:
- Adolescent obesity is a growing public health concern with significant long-term health implications.
- Existing guidelines for pediatric/adolescent weight loss surgery (WLS) require updating based on current evidence.
Purpose of the Study:
- To update evidence-based best practice guidelines for pediatric and adolescent weight loss surgery (WLS).
Main Methods:
- Systematic literature search of English-language studies on WLS in pediatric/adolescent populations (April 2004 - May 2007).
- Searched databases including PubMed, MEDLINE, and Cochrane Library using relevant keywords.
- Reviewed 186 of over 1,085 identified papers, grading evidence using established models.
Main Results:
- Recommended modification of selection criteria for WLS in adolescents.
- Suggest including adolescents with BMI >= 35 and specific comorbidities (e.g., type 2 diabetes, severe steatohepatitis, pseudotumor cerebri, obstructive sleep apnea).
- Consider WLS for adolescents with extreme obesity (BMI >= 40) and associated long-term risks.
Conclusions:
- Evidence supports updating WLS guidelines for adolescents to improve patient selection and outcomes.
- Emphasized the need for regular guideline updates to incorporate technological advancements and new research.
- Highlighted key patient safety considerations: selection criteria, multidisciplinary evaluation, procedure choice, comorbidity management, compliance, and informed consent.
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