Abstract
BackgroundRecent studies have indicated that bariatric surgery is effective for the treatment of youth with severe obesity. The attitudes of pediatricians, parents, and adolescents regarding this topic remain unclear. Therefore, the aim of this study was to assess the current thoughts and beliefs of Dutch pediatricians, parents, and adolescents regarding bariatric surgery in youth.MethodsAn online survey containing twenty questions on bariatric surgery in youth was distributed to pediatricians of the Dutch Society of Pediatrics. Parents and adolescents who participated in an interdisciplinary care program for overweight, obesity, and severe obesity filled out an online survey of twelve questions.ResultsOne hundred and twenty-one pediatricians, 49 parents, and 19 adolescents completed the surveys. Seventy-two pediatricians (59.5%) considered bariatric surgery to be an effective treatment for youth with severe obesity when conventional treatment fails, and intend to refer patients for bariatric surgery. The most frequently suggested conditions for bariatric surgery were a minimum age of 16 years (n = 59, 48.7%), a BMI threshold of 40 kg/m2 (n = 51, 42.2%), and a minimum Tanner stage of IV (n = 59, 48.8%).Thirty parents (61.2%) and fourteen adolescents (73.7%) responded that bariatric surgery should become available for youth with severe obesity.ConclusionDutch pediatricians, parents, and adolescents increasingly accept bariatric surgery as a treatment modality in youth with severe obesity who do not respond successfully to lifestyle intervention. Whether pediatricians will actually refer youth for bariatric surgery remains to be seen when this treatment option will be implemented in the Netherlands.Graphical abstract
Highlights
The worldwide prevalence of overweight and obesity in youth has increased substantially in the last decades; in 2015 more than 100 million children and adolescents were obese [1,2,3]
Ninety-three pediatricians (76.9%) estimated that ≤ 25% of the youth with severe obesity were treated successfully in their hospital. If their treatment was unsuccessful, referral to an obesity expertise center could be the “add on” treatment according to 56 pediatricians (46.3%)
Seven out of the ten pediatricians who would refer for bariatric surgery were working at a pediatric obesity expertise center
Summary
The worldwide prevalence of overweight and obesity in youth has increased substantially in the last decades; in 2015 more than 100 million children and adolescents were obese [1,2,3]. The rising trends of overweight and obesity have plateaued, the rates of severe obesity are still growing with data from 2009 indicating that 0.59% of Dutch boys and 0.53% of Dutch girls were affected by severe obesity [4] This upward trend is concerning when considering the substantial short- and long-term health risks related to severe obesity, such as type 2 diabetes mellitus (T2DM), hypertension, fatty liver disease, and dyslipidemia, even when compared to youth with obesity [5,6,7,8,9]. Obesity Surgery (2021) 31:4821–4828 individual and systemic factors, provided by a pediatric multidisciplinary team These programs have shown to result in a significant decrease in body mass index (BMI) and improvement of cardio-metabolic risk parameters in youth with overweight, obesity, and severe obesity [10,11,12,13]. Conclusion Dutch pediatricians, parents, and adolescents increasingly accept bariatric surgery as a treatment modality in youth with severe obesity who do not respond successfully to lifestyle intervention.
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