A multidisciplinary approach to the adolescent bariatric surgical patient
Section snippets
Materials and methods
Health Works! is a behavioral treatment program at Cincinnati Children’s Hospital Medical Center for pediatric obesity. This physician-supervised interventional weight management program combines the expertise of dieticians, psychologists, and exercise physiologists to treat childhood obesity. To address the needs of patients who do not achieve or sustain weight loss, bariatric surgery was integrated into a comprehensive weight management center (CWMC).
Institutional consensus for CWMC
Results
Since introduction of the CWMC in late 2001, physician referrals have numbered 79 overall (Fig 1). The average BMI of girls in this referral group (n = 48) was 51 kg/m2, whereas the average BMI of boys (n = 31) was 54 kg/m2 (Fig 2). Fifty percent of referrals have been from within a 30-mile radius of Cincinnati, whereas 50% have been long-distance patients.
Using clinical guidelines (Table 1), 25% of all adolescents referred have been considered appropriate candidates for bariatric surgery.
Discussion
Our initial experience suggests that there are a great many adolescents with clinically severe obesity who are interested in a bariatric surgical option to attain a more healthy weight. The evaluation process is more complicated in severely obese adolescents than adults because (1) adolescents have not always made their best attempts at nonsurgical weight loss and can loose weight more effectively with behavioral/dietary measures than adults,32 (2) are often still growing and may be adversely
References (40)
- et al.
Do obese children become obese adults? A review of the literature
Prev Med
(1993) 40-year follow-up of overweight children
Lancet
(1989)- et al.
Body Mass Index at the age of 18 and its effects on 32-year-mortality from coronary heart disease and cancer. A nested case-control study among the entire 1932 Dutch male birth cohort
J Clin Epidemiol
(1989) - et al.
The impact of body mass index of 78,612 18-year old Dutch men on 32-year mortality from all causes
J Clin Epidemiol
(1988) - et al.
Gastric bypass surgery in adolescents with morbid obesity
J Pediatr
(2001) - et al.
Bariatric surgery for severely obese adolescents
J Gastrointest Surg
(2003) - et al.
Gastric bypass for morbid obesity in children and adolescents
J Pediatr Surg
(1980) - et al.
Gastric bypass for morbid obesity in children and adolescents
J Pediatr Surg
(1975) - et al.
Laparoscopic Roux-en-Y gastric bypass in morbidly obese adolescents
J Pediatr Surg
(2003) - et al.
Clinical longitudinal standards for height and height velocity for North American children
J Pediatr
(1985)
Prevalence and trends in overweight among US children and adolescents, 1999–2000
JAMA
Overweight children and adolescentsDescription, epidemiology, and demographics
Pediatrics
Obesity development during adolescence in a biracial cohortThe NHLBI Growth and Health Study
Pediatrics
Predicting obesity in young adulthood from childhood and parental obesity
N Engl J Med
Childhood predictors of adult obesityA systematic review
Int J Obes Relat Metab Disord
Body mass index during childhood, adolescence and young adulthood in relation to adult overweight and adiposityThe Fels Longitudinal Study
Int J Obes Relat Metab Disord
Health consequences of obesity in youthChildhood predictors of adult disease
Pediatrics
Risk of early death in extremely overweight young men
Br Med J (Clin Res Ed)
Long-term morbidity and mortality of overweight adolescents. A follow-up of the Harvard Growth Study of 1922 to 1935
N Engl J Med
Years of life lost due to obesity
JAMA
Cited by (167)
The multi-disciplinary approach to adolescent bariatric surgery
2014, Seminars in Pediatric Surgery14. Children and Adolescents: Standards of Care in Diabetes— 2024
2024, Diabetes CareThe First-Line Approach in Children with Obstructive Sleep Apnea Syndrome (OSA)
2023, Journal of Clinical MedicineAdolescent metabolic and bariatric surgery: what does the data show?
2023, Annals of Laparoscopic and Endoscopic Surgery14. Children and Adolescents: Standards of Care in Diabetes—2023
2023, Diabetes Care