Surgical Treatment of Obesity in Adolescence
- Author Affiliations: Division of Gastrointestinal and Endocrine Surgery, University of Texas Southwestern Medical Center, Dallas, Texas. Dr Livingston is also a Contributing Editor, JAMA.
Since this article does not have an abstract, we have provided the first 150 words of the full text.
- KEYWORDS:
- ADOLESCENT
- BARIATRIC SURGERY
- GASTRIC BANDING
- LAPAROSCOPY
- OBESITY
- PATIENT COMPLIANCE
- POSTOPERATIVE COMPLICATIONS
- REOPERATION
- RISK FACTORS
- WEIGHT LOSS
Adolescent obesity is a vexing problem for which there are few good solutions. Obese children develop metabolic syndrome. Because the cardiovascular complications of metabolic syndrome result from many years of exposure to hyperglycemia, diabetes, hyperlipidemia, and hypertension, early onset of these problems portends significant disease later in life.1 For these reasons, treating adolescent obesity is important.
How can sustained weight loss be achieved in children and adolescents? As with adults, effective treatments are lacking. Bariatric surgery has been proposed for children but remains controversial. Evidence in support of these operations is based on small-scale studies that have mostly emanated from single institutions reporting outcomes from small numbers of patients with inadequate follow-up.2 Most studies have investigated gastric bypass–type procedures. Because these operations permanently alter the stomach, most clinicians are reluctant to advise these operations for children or adolescents except in the most compelling circumstances. Laparoscopic adjustable banding operations …
