Update on pediatric metabolic and bariatric surgery

Abstract

Summary The prevalence of childhood obesity has risen sharply over the last several decades and poses a significant threat to the health and well‐being of today's youth. Childhood‐onset obesity is associated with a number of cardiometabolic consequences, which contribute to diminished quality of life. Metabolic and bariatric surgery offers a powerful treatment paradigm with positive long‐term health effects. A growing body of literature supports the notion that earlier intervention in younger patients results in long‐term health benefits. The development of a multidisciplinary care model and best practice guidelines are central to providing optimal care for this vulnerable patient population. Although the outcomes of metabolic and bariatric surgery in pediatric patients are reassuring and support the ongoing utilization of this important treatment paradigm, a number of significant challenges remain regarding access to care. As the literature continues to support earlier intervention for youth with severe obesity, future efforts should address these challenges to ensure that eligible patients are referred in timely fashion.

From surgery to endoscopy: the evolution of the bariatric discipline

“…Currently, the most widely used surgical bariatric procedures for children, adolescents, and adults are SG and RYGB. Compared with RYGB, SG is simpler, and the risk of nutrient deficiency is lower, and so the advantages are more obvious [75] . Due to the higher incidence of complications, BPD-DS and AGB have gradually been withdrawn from mainstream use in recent years and are currently not recommended for weight loss in young people [72] .…”

“…Compared with RYGB, SG is simpler, and the risk of nutrient deficiency is lower, and so the advantages are more obvious. [ 75 ] Due to the higher incidence of complications, BPD-DS and AGB have gradually been withdrawn from mainstream use in recent years and are currently not recommended for weight loss in young people. [ 72 ] For adolescents, a minimally invasive and reversible endoscopic bariatric strategy may be a more worthwhile option than RYGB or SG.…”