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Pediatric Metabolic and Bariatric Surgery

Adi Steinhart1, Deborah Tsao2, Janey S A Pratt3

  • 1Department of Pediatrics, Stanford University School of Medicine, 1017 Paradise Way, Palo Alto, CA 94306, USA.

The Surgical Clinics of North America
|March 21, 2021
PubMed

Insights

Severe childhood obesity requires early intervention, including metabolic and bariatric surgery, to improve long-term health and survival. Lifestyle changes alone are insufficient for treating this complex condition.

Area of Science:

  • Pediatric Endocrinology
  • Public Health
  • Genetics

Background:

  • Childhood obesity is a serious health issue linked to reduced quality of life and premature death.
  • Obesity has a polygenic etiology, and recognizing this can reduce implicit bias in treatment.
  • Current treatments often fail to adequately address severe pediatric obesity.

Purpose of the Study:

  • To highlight the inadequacy of current treatments for severe childhood obesity.
  • To advocate for early referral to multidisciplinary centers for severe pediatric obesity.
  • To emphasize the benefits of timely intervention on quality and quantity of life.

Main Methods:

  • Review of current guidelines for severe childhood obesity treatment.
  • Analysis of the etiological factors contributing to childhood obesity.
  • Evaluation of the effectiveness of various treatment modalities.

Main Results:

  • Severe childhood obesity significantly decreases health-related quality of life and increases mortality risk.
  • Metabolic and bariatric surgery is recommended for severe obesity at any age when BMI exceeds 120% of the 95th percentile.
  • Medications and lifestyle counseling are insufficient for severe cases.

Conclusions:

  • Early referral to specialized multidisciplinary treatment centers is crucial for managing severe childhood obesity.
  • Timely intervention, including surgical options, can substantially improve both the quality and duration of life for affected children.
  • Recognizing obesity as a complex, polygenic disease is essential for effective and unbiased care.

Keywords:
AdolescentBariatricObesityPediatricSurgery

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