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Open Access Publications from the University of California

Trimming Adolescent Obesity: Is Surgery the Answer?

  • Author(s): Van Allen, Eliezer M
  • et al.

The pervasiveness of obese children and adolescents in the United States has almost tripled in the past 30 years, and current conservative estimates indicate that 15.5% of children and adolescents are obese (defined as body mass index [BMI] of 95th percentile for age). Given this, it is necessary to identify whether bariatric surgery should be indicated for obese adolescents. The Roux-en-Y gastric bypass (RYGB) and adjustable gastric banding (AGB) have been used to treat morbidly obese adolescents, and this paper reviewed primary clinical studies that examined the efficacy of each procedure in this population. Multiple studies confirm that both procedures produce significant weight loss in morbidly obese adolescents. However, there is currently no definitive evidence demonstrating one procedure to be superior to the other, or either procedure being superior to non-surgical weight loss treatments. Most troubling is the fact that only one study outlined comprehensive guidelines for adolescent patient management before, during, and after surgery with provisions for nutritional and psychological counseling. Therefore, more research is needed to prove the efficacy and safety of gastric bypass surgery in morbidly obese adolescents, and currently this treatment should be reserved for the most severely obese adolescents for which all other forms of treatment have failed.

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