 |
|
 |
|
 |
 |
|
 |
 |
 |
 |
 |
 |
 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
SPECIAL ARTICLE |
* Departments of Pediatric Surgery
*** Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
Section of Nutrition, Department of Pediatrics, University of Colorado Health Sciences Center, Denver, Colorado
Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics
|| Department of Surgery
## Division of Pediatric Surgery, Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, Wisconsin
¶ Johnson & Johnson Pharmaceutical Research and Development, Titusville, New Jersey
# Division of Pediatric Surgery, Department of Surgery, Lucile Packard Children's Hospital
Department of Pediatrics, Stanford University Medical Center, Stanford, California
** Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery
¶¶ Division of Gastroenterology and Nutrition, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
Division of Pediatric Surgery, Children's Hospital of Alabama, University of Alabama at Birmingham, Birmingham, Alabama
|| Division of Pediatric Surgery, Department of Surgery, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
As the prevalence of obesity and obesity-related disease among adolescents in the United States continues to increase, physicians are increasingly faced with the dilemma of determining the best treatment strategies for affected patients. This report offers an approach for the evaluation of adolescent patients' candidacy for bariatric surgery. In addition to anthropometric measurements and comorbidity assessments, a number of unique factors must be critically assessed among overweight youths. In an effort to reduce the risk of adverse medical and psychosocial outcomes and increase compliance and follow-up monitoring after bariatric surgery, principles of adolescent growth and development, the decisional capacity of the patient, family structure, and barriers to adherence must be considered. Consideration for bariatric surgery is generally warranted only when adolescents have experienced failure of 
6 months of organized weight loss attempts and have met certain anthropometric, medical, and psychologic criteria. Adolescent candidates for bariatric surgery should be very severely obese (defined by the World Health Organization as a body mass index of 40), have attained a majority of skeletal maturity (generally 13 years of age for girls and 15 years of age for boys), and have comorbidities related to obesity that might be remedied with durable weight loss. Potential candidates for bariatric surgery should be referred to centers with multidisciplinary weight management teams that have expertise in meeting the unique needs of overweight adolescents. Surgery should be performed in institutions that are equipped to meet the tertiary care needs of severely obese patients and to collect long-term data on the clinical outcomes of these patients.
Key Words: bariatric surgery • gastric bypass • adjustable gastric band • adolescence • obesity • overweight
Abbreviations: BMI, body mass index • AGB, adjustable gastric banding
This article has been cited by other articles:
 |
|
 |
|
  C. B. JASIK and R. H. LUSTIG Adolescent Obesity and Puberty: The "Perfect Storm" Ann. N.Y. Acad. Sci., June 1, 2008; 1135(1): 265 - 279. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. A. Matyka Type 2 diabetes in childhood: epidemiological and clinical aspects Br. Med. Bull., June 1, 2008; 86(1): 59 - 75. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. M. Ippisch, T. H. Inge, S. R. Daniels, B. Wang, P. R. Khoury, S. A. Witt, B. J. Glascock, V. F. Garcia, and T. R. Kimball Reversibility of Cardiac Abnormalities in Morbidly Obese Adolescents J. Am. Coll. Cardiol., April 8, 2008; 51(14): 1342 - 1348. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. E. Barlow and and the Expert Committee Expert Committee Recommendations Regarding the Prevention, Assessment, and Treatment of Child and Adolescent Overweight and Obesity: Summary Report Pediatrics, December 1, 2007; 120(Supplement_4): S164 - S192. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. F. Krebs, J. H. Himes, D. Jacobson, T. A. Nicklas, P. Guilday, and D. Styne Assessment of Child and Adolescent Overweight and Obesity Pediatrics, December 1, 2007; 120(Supplement_4): S193 - S228. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. A. Spear, S. E. Barlow, C. Ervin, D. S. Ludwig, B. E. Saelens, K. E. Schetzina, and E. M. Taveras Recommendations for Treatment of Child and Adolescent Overweight and Obesity Pediatrics, December 1, 2007; 120(Supplement_4): S254 - S288. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. J. DeMaria Bariatric Surgery for Morbid Obesity N. Engl. J. Med., May 24, 2007; 356(21): 2176 - 2183. [Full Text] [PDF]
|
|
|
|
 |
|
 E. Heubeck Reversible Surgery Gains Favor for Adolescents DOC News, May 1, 2007; 4(5): 8 - 9. [Full Text]
|
|
|
|
 |
|
 W. S. Tsai, T. H. Inge, and R. S. Burd Bariatric Surgery in Adolescents: Recent National Trends in Use and In-Hospital Outcome Arch Pediatr Adolesc Med, March 1, 2007; 161(3): 217 - 221. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Z. T. Bloomgarden Weight Control in Individuals With Diabetes Diabetes Care, December 1, 2006; 29(12): 2749 - 2754. [Full Text] [PDF]
|
|
|
|
 |
|
 J J Reilly Tackling the obesity epidemic: new approaches. Arch. Dis. Child., September 1, 2006; 91(9): 724 - 726. [Full Text] [PDF]
|
|
|
|
|
|
J. L. Zitsman Pediatric Minimal-Access Surgery: Update 2006 Pediatrics, July 1, 2006; 118(1): 304 - 308. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J J Reilly Obesity in childhood and adolescence: evidence based clinical and public health perspectives. Postgrad. Med. J., July 1, 2006; 82(969): 429 - 437. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. H. Zeller, H. R. Roehrig, A. C. Modi, S. R. Daniels, and T. H. Inge Health-Related Quality of Life and Depressive Symptoms in Adolescents With Extreme Obesity Presenting for Bariatric Surgery Pediatrics, April 1, 2006; 117(4): 1155 - 1161. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M Druce and S R Bloom The regulation of appetite Arch. Dis. Child., February 1, 2006; 91(2): 183 - 187. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. M. Davis, K. Slish, C. Chao, and M. D. Cabana National Trends in Bariatric Surgery, 1996-2002 Arch Surg, January 1, 2006; 141(1): 71 - 74. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Where to Begin With the Extremely Obese Child DOC News, December 1, 2005; 2(12): 5 - 5. [Full Text]
|
|
|
|
 |
|
 R. D. Feigin Prospects for the Future of Child Health Through Research JAMA, September 21, 2005; 294(11): 1373 - 1379. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Robbins Guidelines for the Treatment of Obesity AAP Grand Rounds, September 1, 2005; 14(3): 31 - 32. [Full Text] [PDF]
|
|
|
|
 |
|
 A. U. Bauchowitz, L. A. Gonder-Frederick, M.-E. Olbrisch, L. Azarbad, M.-Y. Ryee, M. Woodson, A. Miller, and B. Schirmer Psychosocial Evaluation of Bariatric Surgery Candidates: A Survey of Present Practices Psychosom Med, September 1, 2005; 67(5): 825 - 832. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. E. Encinosa, D. M. Bernard, C. A. Steiner, and C.-C. Chen Use And Costs Of Bariatric Surgery And Prescription Weight-Loss Medications Health Aff., July 1, 2005; 24(4): 1039 - 1046. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. H. Dietz and T. N. Robinson Overweight Children and Adolescents N. Engl. J. Med., May 19, 2005; 352(20): 2100 - 2109. [Full Text] [PDF]
|
|
|
|
 |
|
 S. R. Daniels, D. K. Arnett, R. H. Eckel, S. S. Gidding, L. L. Hayman, S. Kumanyika, T. N. Robinson, B. J. Scott, S. St. Jeor, and C. L. Williams Overweight in Children and Adolescents: Pathophysiology, Consequences, Prevention, and Treatment Circulation, April 19, 2005; 111(15): 1999 - 2012. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. H. Inge Report offers guidelines for bariatric surgery in youths AAP News, March 1, 2005; 26(3): 26 - 27. [Full Text] [PDF]
|
|
|
|
|
|
V. F. Garcia Adolescent Bariatric Surgery: Treatment Delayed May Be Treatment Denied Pediatrics, March 1, 2005; 115(3): 822 - 823. [Full Text] [PDF]
|
|
|
|
|
|
Journal Watch Arch. Dis. Child., February 1, 2005; 90(2): 216 - 217. [Full Text] [PDF]
|
|
|
|
|
|
C. G. Solomon and R. G. Dluhy Bariatric Surgery -- Quick Fix or Long-Term Solution? N. Engl. J. Med., December 23, 2004; 351(26): 2751 - 2753. [Full Text] [PDF]
|
|
|
|
 |
|
 When All Else Fails: Bariatric Surgery for Severely Obese Adolescents Journal Watch Pediatrics and Adolescent Medicine, October 12, 2004; 2004(1012): 5 - 5. [Full Text]
|
|
|
|
|
|
S. E. Barlow Bariatric Surgery in Adolescents: For Treatment Failures or Health Care System Failures? Pediatrics, July 1, 2004; 114(1): 252 - 253. [Full Text] [PDF]
|
|
|
|
|
|
A. C. Wittgrove Surgery for Severely Obese Adolescents: Further Insight From the American Society for Bariatric Surgery Pediatrics, July 1, 2004; 114(1): 253 - 254. [Full Text] [PDF]
|
|
|
|
|
|
B. M. Rodgers Bariatric Surgery for Adolescents: A View From the American Pediatric Surgical Association Pediatrics, July 1, 2004; 114(1): 255 - 256. [Full Text] [PDF]
|
|
 |
||
|
||
Home | My Pediatrics | Journal Information | Current Issue | Past Issues | Subscriptions & Services | Contact Us Click here for faster international access © 2004 American Academy of Pediatrics. All rights reserved. |
||
|
||
