Pediatric Metabolic and Bariatric Surgery: Evidence, Barriers, and Best Practices

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TABLE 1

Indications and Contraindications for Adolescent Metabolic and Bariatric Surgery

Wt Criteria	Comorbid Conditions
Class 2 obesity, BMI ≥35, or 120% of the 95th percentile for age and sex, whichever is lower	Clinically significant disease, including obstructive sleep apnea (AHI >5), T2DM, IIH, NASH, Blount disease, SCFE, GERD, and hypertension
Class 3 obesity, BMI ≥40, or 140% of the 95th percentile for age and sex, whichever is lower	Not required but commonly present

AHI, Apnea-Hypopnea Index; GERD, gastroesophageal reflux disease; IIH, idiopathic intracranial hypertension; NASH, nonalcoholic steatohepatitis; SCFE, slipped capital femoral epiphysis; T2DM, type 2 diabetes mellitus.