Adolescent Bariatric Surgery: Quality, Outcomes, and Debates

Purpose of Review To provide an updated evaluation of the literature regarding safety and outcomes in pediatric bariatric surgery and to explore associated controversies related to surgical timing and age concerns, as well as other ethical issues. Recent Findings Nonsurgical management of pediatric patients with obesity becomes less effective with increasing age and severity of disease. For carefully selected adolescent patients, bariatric surgery has been shown to provide sustained weight loss, reduction in comorbidities, and improved quality of life; however, high-level evidence is limited. Current data support surgical intervention in obese adolescents prior to adulthood, as several comorbidities and cardiovascular risk factors appear to be increasingly responsive to weight loss at a younger age. There is inadequate information available in pediatric patients to support one type of surgical intervention over another, or weight loss surgery in preadolescent patients. Summary Large trials have begun to more clearly delineate the risks and benefits of adolescent bariatric surgery. As the use of this important intervention increases, it is important that standards of care are agreed upon and that continuing study helps define appropriate patient selection and method of intervention.