Outcomes of Bariatric Surgery in Older Versus Younger Adolescents

Ogle, Sarah; Dewberry, Lindel C.; Jenkins, Todd M.; Inge, Thomas H.; Kelsey, Megan M.; Bruzoni, Matías; Pratt, Janey

doi:10.1542/peds.2020-024182

Cited by 32 publications

(17 citation statements)

References 66 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Other co‐obesity‐related comorbidities such as hypertension, dyslipidaemia and proteinuria were significantly reduced in the Teen‐LABS group 158 . Multiple other studies have supported the role of surgery in reducing obesity‐related comorbidities 159–162 …”

Section: Definitionmentioning

confidence: 81%

Childhood obesity: A review of current and future management options

Apperley

Blackburn

Erlandson-Parry

et al. 2021

Clinical Endocrinology

View full text Add to dashboard Cite

Obesity is becoming increasingly prevalent in paediatric populations worldwide. In addition to increasing prevalence, the severity of obesity is also continuing to rise. Taken together, these findings demonstrate a worrying trend and highlight one of the most significant challenges to public health. Childhood obesity affects multiple organs in the body and is associated with both significant morbidity and ultimately premature mortality. The prevalence of complications associated with obesity, including dyslipidaemia, hypertension, fatty liver disease and psychosocial complications are becoming increasingly prevalent within the paediatric populations. Treatment guidelines currently focus on intervention with lifestyle and behavioural modifications, with pharmacotherapy and surgery reserved for patients who are refractory to such treatment. Research into adult obesity has established pharmacological novel therapies, which have been approved and established in clinical practice; however, the research and implementation of such therapies in paediatric populations have been lagging behind. Despite the relative lack of widespread research in comparison to the adult population, newer therapies are being trialled, which should allow a greater availability of treatment options for childhood obesity in the future. This review summarizes the current evidence for the management of obesity in terms of medical and surgical options. Both future therapeutic agents and those which cause weight loss but have an alternative indication are also included and discussed as part of the review. The review summarizes the most recent research for each intervention and demonstrates the potential efficacy and limitations of each treatment option.

show abstract

Section: Definitionmentioning

confidence: 81%

Childhood obesity: A review of current and future management options

Apperley

Blackburn

Erlandson-Parry

et al. 2021

Clinical Endocrinology

View full text Add to dashboard Cite

show abstract

“…Initial results after bariatric surgery in morbidly obese adolescents with metabolic comorbidities suggested that these procedures improved an impaired glucose metabolism and other cardiometabolic comorbidities even in this age group and could even be more effective than in adults [ 67 , 68 , 69 ]. Moreover, there are only few differences in the outcome of bariatric surgery (RYGB and SG) between younger and older adolescents, suggesting that younger adolescents with severe obesity should not be denied consideration for surgical therapy [ 70 ].…”

Section: Discussionmentioning

confidence: 99%

Update on Metabolic Bariatric Surgery for Morbidly Obese Adolescents

et al. 2021

View full text Add to dashboard Cite

Despite worldwide public attention and intense medical efforts, the prevalence of severe morbid obesity in children and adolescents is still rising. Similar to adults, excess adipose tissue triggers multiple immunological and metabolic pathways leading to serious co-morbidities such as impaired glucose tolerance or even type 2 diabetes (T2D), dyslipidemia, arterial hypertension, non-alcoholic fatty liver disease, and hyperuricemia. The management of severe childhood obesity requires a life-long multidisciplinary approach with a combination of lifestyle changes, nutrition, and medications. Standardized life-style intervention programs remain the first-line treatment for morbid obese children and adolescents, but unfortunately reveal limited long-term success. In such cases, metabolic bariatric surgery (MBS) has evolved from being a controversial issue to being included in distinct recommendations. According to the American Society for Metabolic and Bariatric Surgery (ASMBS) Pediatric Committee, indications for bariatric surgery in adolescence must follow very strict criteria. Adolescents with class II obesity (BMI > 120% of the 95th percentile) and a diagnosed co-morbidity or with class III obesity (BMI ≥ 140% of the 95th percentile) should be considered for MBS. These interventions represent high-risk operations, and adolescents should be treated in specialized, multidisciplinary high-volume obesity centers with long-term follow-up programs. The Roux-en-Y gastric bypass (RYGB) remains the gold standard of all malabsorptive procedures. Laparoscopic sleeve gastrectomy (LSG), which the authors pioneered as a stand-alone procedure in morbidly obese adolescents in 2008, has become the most commonly performed operation in morbidly obese adolescents at present. Recent literature proves that MBS is safe and effective in morbidly obese adolescents. Mid-term data have revealed significant improvement or even resolution of major co-morbidities. Thus, MBS for the treatment of morbidly obese adolescents has evolved from being a controversial issue to being included in distinct recommendations by several medical societies as a therapeutic strategy to reduce severe co-morbidities potentially causing end-organ damage in adulthood.

show abstract

“…A recent study by Ogle, Dewberry, Jenkins et al examined 5-year outcomes of patients who underwent bariatric surgery from two cohorts: younger (age 13–15 years) and older (age 16–19 years). They found few differences in outcome in these two cohorts, to include percentage weight loss after 5 years, improvement or resolution of hypertension, type 2 diabetes, dyslipidemia, nutritional abnormalities and quality of life [29 ▪ ].…”

Section: Metabolic and Bariatric Surgerymentioning

confidence: 99%

Progress in pediatric obesity: new and advanced therapies

Cuda¹,

Censani

2022

Current Opinion in Pediatrics

View full text Add to dashboard Cite

Purpose of reviewIn this review, we discuss new medical and surgical options for the treatment of children and adolescents with obesity. We review the impact of COVID-19 on this vulnerable population. We also discuss the recent availability of screening tests for rare genetic causes of obesity.Recent findingsCOVID-19 increased the prevalence of obesity among children and adolescents. This population is at increased risk for severe disease. The field of pediatric obesity has benefited from the approval of two new antiobesity medications: liraglutide and setmelanotide. We discuss indications for their use. New guidelines for surgical options for the treatment of children and adolescents with obesity are reviewed. These options are increasingly used as part of the comprehensive care for these children.SummaryThe epidemic of childhood obesity continues. COVID-19 and the associated isolation contributed to the problem. However, promising new medical and surgical therapies and screening tests for rare genetic causes of obesity are available. These new diagnostic and therapeutic options bring renewed enthusiasm to the treatment of children and adolescents with obesity and increased recognition that obesity is a chronic disease starting in childhood deserving intervention to prevent consequences.

show abstract

Outcomes of Bariatric Surgery in Older Versus Younger Adolescents

Cited by 32 publications

References 66 publications

Childhood obesity: A review of current and future management options

Childhood obesity: A review of current and future management options

Update on Metabolic Bariatric Surgery for Morbidly Obese Adolescents

Progress in pediatric obesity: new and advanced therapies

Contact Info

Product

Resources

About