Adolescent bariatric surgery is one way clinicians are attempting to solve the problem of childhood obesity. In 2004, the Food and Drug Administration (FDA) granted investigational device exemption of the adjustable gastric band to determine the safety and efficacy of gastric banding in morbidly obese adolescents. The role of the dietitian in the multidisciplinary adolescent bariatric team is challenging. It is the responsibility of the dietitian to improve the adolescent's diet quality prior to surgery, teach the adolescent and the family the new eating guidelines after surgery, and to assess the nutritional adequacy of the diet post operatively. This article reviews the preoperative nutrition management, the nutrition guidelines followed for adolescents undergoing gastric banding surgery at Alfred I. duPont Hospital for Children, and reviews the unique challenges that working with adolescents presents to dietitians.