Adolescent Bariatric Surgery

Abstract

The stark increase in global obesity encompasses not only adult population but also pediatric and adolescent population. Morbidly obese adolescents are highly likely to suffer from obesity as adults; enduring some of the same obesity related comorbid disease states with little to no medical options for long term weight loss. These comorbidities tend to have already had a significant impact on their health even as young adults. There are specific guidelines that have been set up for the surgical treatment of morbid obesity in adolescents, which readily align with adult recommendations. The timing of surgery is important given the multitude of medical as well as psychosocial issues that need to be addressed. Recent prospective trials have demonstrated that bariatric surgery in the adolescent population is safe and effective. Roux-en-Y gastric bypass remains the gold standard. The advent of vertical sleeve gastrectomy has supplanted the adjustable gastric banding procedure as the second most commonly performed procedure and is quickly gaining favor amongst many adolescent bariatric surgeons. The general postoperative management of these patients is similar to their adult counterparts with particular attention paid to psychosocial support, frequent follow up, vitamin supplementation, and birth control. As the pool of knowledge regarding bariatric surgery in this population of patients continues to grow, especially the long term response of adolescent to bariatric surgery, the surgical treatment for the morbidly obese adolescent will continue to gain credence as a front line treatment.