Surgical approach to adolescent obesity

As the epidemic of pediatric obesity has been documented increasingly, and the efficacy and safety of bariatric surgery also have become evident, more attention has been given to consideration of bariatric surgical interventions for clinically severely obese adolescents. Principles of adolescent medicine and evidence from adult bariatric surgical experience can be used to rationally guide the application of bariatric procedures to a group of young patients who have serious medical and psychological comorbidities of severe obesity. This article focuses primarily on a discussion of (1) the indications for bariatric surgical intervention in adolescence, (2) the team approach to delivery of bariatric services in this age group, (3) principles of perioperative and postoperative patient management, (4) the surgical procedures available for weight loss, and (5) the results of bariatric surgical intervention in adolescence.