Preparing Adolescents for Bariatric Surgery: Foundational Elements Applying Erikson's Theory of Human Development

Abstract

Obesity prevention is a national initiative with the attention of First Lady Michelle Obama and is being addressed on many levels with a multifactorial approach. However, many children and adolescents are beyond the benefit of prevention efforts and need treatment. Bariatric surgery in the adolescent population is a broadly debated topic that generates valuable discussion about the management of childhood obesity. This article seeks to describe the unique and pertinent developmental aspects of preparation and support given to obese adolescents and their families, and to present the experience at the University of Illinois Medical Center Adolescent Weight Management Program in Chicago, Illinois. There is a lack of scientific evidence in the current literature addressing what factors influence an adolescent's success with weight loss surgery, or clinical practice guidelines that outline recommendations for preparation of adolescents for bariatric surgery. It is the hope that reporting this experience will stimulate more scientific inquiry in this area. The purpose of this article is to encourage the provider to focus toward assisting the adolescent through the educational and psychosocial stages, with a goal of creating a solid foundation for success with bariatric surgery. The following stages and themes are noted from our clinical and management experience with adolescents in a weight management program that included the option of bariatric surgery. Erikson's Psychosocial Theory of Human Development1 was the construct for the developmental care provided in this novel program at the University of Illinois Medical Center.