Adolescent Bariatric Surgery: Current Concepts and Future Directions

Abstract

This review intends to discuss the current status of childhood and adolescent bariatric surgery, including short- and mid-term outcomes, complications, and controversies. Additionally we will highlight potential future directions of pediatric weight loss procedures specifically in regard to procedures. To date, adolescent bariatric surgery appears to be the most effective way to treat adolescent and pediatric obesity in the short term. Not only does surgery offer the benefit of significant weight loss that is sustainable based on adult literature and the short-term data that we have in pediatric and adolescent literature, but there are significant improvements and resolutions to obesity-associated comorbidities. The recent literature converge on the importance and necessity of further studies which follow patients into adulthood in order to provide a better understanding of the long-term effects of surgery on the adolescent population, resolution of comorbidities, the benefits to the patient, and the impact on life expectancy. Adolescent surgical outcomes and comorbidities appear to mimic adult data, and some studies show that children and adolescents respond better to bariatric surgery with better results than the adults in regard to comorbidities. Effective management of overweight and obese pediatric and adolescent patients requires early identification and surgery for those patients who would most benefit from surgical treatment. To date, pharmacotherapy, behavior modification, and dietary changes do not have long-term sustainability in regard to maintaining a healthy weight in these children. Appropriate utilization of bariatric surgery among the pediatric and adolescent population is important in preventing obesity transmission, and its complications, into adulthood. Long-term data will address many questions and concerns of parents, patients, and primary care physicians. Until effective non-surgical options become available, weight loss surgery is the only viable option. Future endeavors and new research favor creation and use of less invasive safer procedures that incur less risk with maximum benefit, and study of the patients’ unique physiology in a search for different treatments as well as prevention options.