Bariatric Surgery for Adolescents

This is such an important statement.  The designation of “standard of care” is very important.  Bariatric surgery is NOT an extreme method of curing the disease of obesity in adolescents.  It is NOT an experimental procedure to treat teenage obesity.  Instead, bariatric surgery is “the STANDARD of care” for treating the disease. In other words, bariatric surgery is an accepted and proven treatment for the treatment of obesity in adolescents and should be offered to any adolescent who meets the criteria.  Simply put, bariatric surgery is a medical treatment that makes weight loss possible.

The treatment of obesity in adolescents has lagged behind the treatment of the disease in adults.  In adults, we have made significant progress in improving access to the life-changing and life-saving surgical treatment of this disease.   However, in teenagers, surgical treatment of obesity has largely been withheld. Oftentimes, if a teenager with obesity presented to his pediatrician, the proposed treatment was a cursory recommendation for “diet and exercise”. This is not sufficient treatment based on our understanding of the disease of obesity, and therefore, inevitably fails.

We know the cost of failing to treat obesity in teenagers.  We know that the disease of obesity is extremely determinantal to their health.  Not only does it lead to diabetes, heart disease, and early-onset arthritis, but the physiological toll it enacts on teenagers is extreme.  We see so many teenagers who have been bullied and ridiculed because of their weight. This psychological stress leads to depression and anxiety, and many stay away from school or perform poorly at school.

We have the ability to rescue these teenagers and help them conquer their disease.  Multiple large-scale and long-term studies have clearly shown that bariatric surgery is an effective, long-lasting, and safe treatment for the disease of obesity in adolescents.   Earlier treatment for the disease of obesity offers patients a chance for a healthy future, without the risk of persistent obesity and associated co-morbidities.  Bariatric surgery should be considered for all adolescent patients who meet criteria with the input from parents, pediatricians, therapists, and dietitians.