Metabolic and bariatric surgery in pediatrics

Abstract

1) Obesity is an epidemic in the adolescent population. Surgery for obesity provides the best long-term outcomes for sustained weight loss and resolution of comorbidities. 2) Indications for metabolic and bariatric surgery include (A) BMI ≥35 kg/m2 or 120% of the 95th percentile with clinically a significant comorbid condition, or (B) BMI ≥40 kg/m2 or 140% of the 95th percentile (whichever is lower), in addition to readiness for change, and the ability of the patient and family to adhere to treatments pre-and postoperatively. 3) Vertical sleeve gastrectomy is the most common weight loss procedure performed in adolescents. Roux-en-Y gastric bypass may be preferred in patients with severe gastroesophageal reflux disease. 4) A dedicated adolescent bariatric surgery program with lifelong monitoring postoperatively is essential for optimal patient outcomes.