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PEDIATRICS Vol. 114 No. 1 July 2004, pp. 252-253

COMMENTARY

Bariatric Surgery in Adolescents: For Treatment Failures or Health Care System Failures?

Sarah E. Barlow, MD, MPH

Division of Gastroenterology and Hepatology,
St Louis University School of Medicine,
St Louis, MO 63104-1095

The first 20% of the full text of this article appears below.

More and more children are obese, and more and more of them are severely obese.1 As a result, children now experience severe consequences of obesity that until recently were considered diseases of adulthood, such as type 2 diabetes. Given the serious physical morbidity of obesity as well as the profound impairment of quality of life and function, we inevitably must consider the role of bariatric surgery, an aggressive and potentially risky treatment that until recently was reserved for adults. In this issue of Pediatrics, Inge et al, a panel of experienced pediatricians and surgeons, present recommendations to guide patient selection, surgical management, and long-term follow-up.2

The panel emphasizes the risks of surgery and the paucity of data, both short-term and long-term, among adolescents. The report recommends caution in patient selection. It proposes conservative physiologic criteria based on body mass index levels, medical comorbidities, and physiologic maturity, and it endorses psychological health and family support before and after surgery. The panel recommends surgery only after the child has attempted other treatment. In fact, first on the panel’s list . . . [Full Text of this Article]

Address correspondence to Sarah E. Barlow, MD, MPH, Division of Gastroenterology and Hepatology, SSM Cardinal Glennon Children’s Hospital, 1465 S Grand Blvd, St Louis, MO 63104-1095. E-mail: barlowse@slu.edu




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