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. 2022 Sep 8;9(9):CD011740.
doi: 10.1002/14651858.CD011740.pub2.

Surgery for the treatment of obesity in children and adolescents

Gabriel Torbahn  1   2   3 , Jana Brauchmann  4 , Emma Axon  5 , Ken Clare  6 , Maria-Inti Metzendorf  7 , Susanna Wiegand  4 , Janey Sa Pratt  8 , Louisa J Ells  9
Affiliations

Surgery for the treatment of obesity in children and adolescents

Gabriel Torbahn et al. Cochrane Database Syst Rev. .

Abstract

Background: Child and adolescent overweight and obesity have increased globally and are associated with significant short- and long-term health consequences.

Objectives: To assess the effects of surgery for treating obesity in childhood and adolescence.

Search methods: For this update, we searched Cochrane Central Register of Controlled Trials, MEDLINE, Latin American and Caribbean Health Science Information database (LILACS), World Health Organization International Clinical Trials Registry Platform (ICTRP)and ClinicalTrials.gov on 20 August 2021 (date of the last search for all databases). We did not apply language restrictions. We checked references of identified studies and systematic reviews.

Selection criteria: We selected randomised controlled trials (RCTs) of surgical interventions for treating obesity in children and adolescents (age < 18 years) with a minimum of six months of follow-up. We excluded interventions that specifically dealt with the treatment of eating disorders or type 2 diabetes, or which included participants with a secondary or syndromic cause of obesity, or who were pregnant.

Data collection and analysis: We used standard methodological procedures expected by Cochrane. Two review authors independently extracted data and assessed the risk of bias using the Cochrane Risk of Bias 2.0 tool. Where necessary, we contacted authors for additional information.

Main results: With this update, we did not find any new RCTs. Therefore, this updated review still includes a single RCT (a total of 50 participants, 25 in both the intervention and comparator groups). The intervention focused on laparoscopic adjustable gastric banding surgery, which was compared to a control group receiving a multi-component lifestyle programme. The participating population consisted of Australian adolescents (a higher proportion of girls than boys) aged 14 to 18 years, with a mean age of 16.5 and 16.6 years in the gastric banding and lifestyle groups, respectively. The trial was conducted in a private hospital, receiving funding from the gastric banding manufacturer. For most of the outcomes, we identified a high risk of bias, mainly due to bias due to missing outcome data. Laparoscopic gastric banding surgery may reduce BMI by a mean difference (MD) of -11.40 kg/m2 (95% CI -13.22 to -9.58) and weight by -31.60 kg (95% CI -36.66 to -26.54) compared to a multi-component lifestyle programme at two years follow-up. The evidence is very uncertain due to serious imprecision and a high risk of bias. Adverse events were reported in 12/25 (48%) participants in the intervention group compared to 11/25 (44%) in the control group. A total of 28% of the adolescents undergoing gastric banding required revisional surgery. The evidence is very uncertain due to serious imprecision and a high risk of bias. At two years of follow-up, laparoscopic gastric banding surgery may increase health-related quality of life in the physical functioning scores by an MD of 16.30 (95% CI 4.90 to 27.70) and change in health scores by an MD of 0.82 (95% CI 0.18 to 1.46) compared to the lifestyle group. The evidence is very uncertain due to serious imprecision and a high risk of bias. No data were reported for all-cause mortality, behaviour change, participants' views of the intervention and socioeconomic effects. Finally, we have identified three ongoing RCTs that are evaluating the efficacy and safety of metabolic and bariatric surgery in children and adolescents.

Authors' conclusions: Laparoscopic gastric banding led to greater body weight loss compared to a multi-component lifestyle program in one small study with 50 participants. These results have very limited application, primarily due to more recent recommendations derived from observation studies to avoid the use of banding in youth due to long-term reoperation rates. This systematic review update still highlights the lack of RCTs in this field. The authors are concerned that there may be ethical barriers to RTCs in this field, despite the lack of other effective therapies for severe obesity in children and adolescents and the significant morbidity and premature mortality caused by childhood obesity. Nevertheless, future studies, whether pre-registered and planned non-randomised or pragmatic randomised trials, should assess the impact of the surgical procedure and post-operative care to minimise adverse events, including the need for post-operative adjustments and revisional surgery. Long-term follow-up is also critical to comprehensively assess the impact of surgery as participants enter adulthood.

PubMed Disclaimer

Conflict of interest statement

GT: none known.

JB: none known.

EA: none known.

KC: Boehringer Ingelheim (Independent Contractor ‐ Other), Apollo Endosurgery US Inc (Independent Contractor ‐ Other), Novo Nordisk (Independent Contractor ‐ Other).

MIM: none known.

JSAP: none known.

SW: none known.

LJE: none known.

Figures

1
1
1.1
1.1. Analysis
Comparison 1: Surgery compared with usual care (non‐surgery intervention), Outcome 1: BMI loss
1.2
1.2. Analysis
Comparison 1: Surgery compared with usual care (non‐surgery intervention), Outcome 2: Weight loss
1.3
1.3. Analysis
Comparison 1: Surgery compared with usual care (non‐surgery intervention), Outcome 3: Adverse events
1.4
1.4. Analysis
Comparison 1: Surgery compared with usual care (non‐surgery intervention), Outcome 4: Health‐related quality of life (physical functioning)
1.5
1.5. Analysis
Comparison 1: Surgery compared with usual care (non‐surgery intervention), Outcome 5: Health‐related quality of life (change in health)
1.6
1.6. Analysis
Comparison 1: Surgery compared with usual care (non‐surgery intervention), Outcome 6: Morbidity (changes in disease status)
1.7
1.7. Analysis
Comparison 1: Surgery compared with usual care (non‐surgery intervention), Outcome 7: Measures of body fat distribution
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References

References to studies included in this review

O'Brien 2010 {published data only}
    1. O'Brien PE, Sawyer SM, Laurie C, Brown WA, Skinner S, Veit F, et al. Laparoscopic adjustable gastric banding in severely obese adolescents. JAMA 2010;303(6):519-26. - PubMed

References to studies excluded from this review

Asaad 2018 {published data only}
    1. Asaad OM. Different ventilation techniques and hemodynamic optimization to maintain regional cerebral oxygen saturation (rScO2) during laparoscopic bariatric surgery: a prospective randomized interventional study. Journal of Anesthesia 2018;32(3):394-402. - PubMed
Bjork 2021 {published data only}
    1. Bjork A, Dahlgren J, Gronowitz E, Henriksson Wessely F, Janson A, Engstrom M, et al. High prevalence of neurodevelopmental problems in adolescents eligible for bariatric surgery for severe obesity. Acta Paediatrica 2021;110(5):1534-40. - PMC - PubMed
de Oliveira 2018 {published data only}
    1. Oliveira LS, Filho ML, Castro JB, Touguinha HM, Silva PC, Ferreira ME. Bariatric surgery repercussions on the quality of life, biochemical profile, and blood pressure of patients with morbid obesity. Fisioterapia e pesquisa 2018;25(3):284-93.
Dewberry 2019 {published data only}
    1. Dewberry LC, Khoury JC, Ehrlich S, Jenkins TM, Beamish AJ, Kalkwarf HJ, et al. Change in gastrointestinal symptoms over the first 5years after bariatric surgery in a multicenter cohort of adolescents. Journal of Pediatric Surgery 2019;54(6):1220-5. - PMC - PubMed
Ebell 2017 {published data only}
    1. Ebell MH. Bariatric surgery improves quality of life and results in more weight loss than intensive medical therapy. American Family Physician 2017;95(12):805. - PubMed
Miller 2017 {published data only}
    1. Miller K, Turro R, Greve JW, Bakker CM, Buchwald JN, Espinos JC. MILEPOST multicenter randomized controlled trial: 12-month weight loss and satiety outcomes after poseSM vs. medical therapy. Obesity Surgery 2017;27(2):310-22. - PubMed
Misra 2020 {published data only}
    1. Misra M, Singhal V, Carmine B, Bose A, Kelsey MM, Stanford FC, et al. Bone outcomes following sleeve gastrectomy in adolescents and young adults with obesity versus non-surgical controls. Bone 2020;134:115290. - PMC - PubMed
Ospanov 2019 {published data only}
    1. Ospanov O, Yeleuov G, Kadyrova I, Bekmurzinova F. The life expectancy of patients with metabolic syndrome after weight loss: study protocol for a randomized clinical trial (LIFEXPE-RT). Trials 2019;20(1):202. - PMC - PubMed
Ponce 2015 {published data only}
    1. Ponce J, Woodman G, Swain J, Wilson E, English W, Ikramuddin S, et al, Investigators Reduce Pivotal Trial. The REDUCE pivotal trial: a prospective, randomized controlled pivotal trial of a dual intragastric balloon for the treatment of obesity. Surgery for Obesity & Related Diseases 2015;11(4):874-81. - PubMed
Schiavon 2020 {published data only}
    1. Schiavon CA, Bhatt DL, Ikeoka D, Santucci EV, Santos RN, Damiani LP, et al. Three-year outcomes of bariatric surgery in patients with obesity and hypertension: a randomized clinical trial. Annals of Internal Medicine 2020;173(9):685-93. - PubMed
Shah 2021 {published data only}
    1. Shah AS, Helmrath MA, Inge TH, Xanthakos SA, Kelsey MM, Jenkins T, et al. Study protocol: a prospective controlled clinical trial to assess surgical or medical treatment for paediatric type 2 diabetes (ST 2 OMP). BMJ Open 2021;11(8):e047766. - PMC - PubMed
Sullivan 2017 {published data only}
    1. Sullivan S, Swain JM, Woodman G, Antonetti M, La Cruz-Munoz N, Jonnalagadda SS, et al. Randomized sham-controlled trial evaluating efficacy and safety of endoscopic gastric plication for primary obesity: The ESSENTIAL trial. Obesity 2017;25(2):294-301. - PubMed
Trastulli 2017 {published data only}
    1. Trastulli S, Desiderio J, Grandone I, Fontana L, Paolini L, Altomare M, et al, Investigators Esinodop trial. Rationale and design of the Early Sleeve gastrectomy In New Onset Diabetic Obese Patients (ESINODOP) trial. Endocrine 2017;55(3):748-53. - PubMed
Varma 2019 {published data only}
    1. Varma S, Lee CJ, Brown TT, Maruthur NM, Schweitzer M, Magnuson T, et al. Comparative effects of medical versus surgical weight loss on body composition: a pilot randomized trial. Obesity Surgery 2019;29(8):2503-10. - PubMed
Zitsman 2020 {published data only}
    1. Zitsman JL, DiGiorgi MF, Zhang AZ, Kopchinski JS, Sysko R, Devlin M J, et al. Adolescent gastric banding: a 5-Year longitudinal study. Obesity Surgery 2020;30(3):828-36. - PubMed

References to ongoing studies

ACTRN12609001004257 {published data only}
    1. Curran JA, Kalic RJ, Sherrington CS, Ravikumara M, Messina D, Mews C, et al. A RCT of Intragastric balloons in obese adolescents: Preliminary data. Obesity Facts 2015;8(Suppl 1):223.
NCT01172899 {published data only}
    1. Roebroek YG, Paulus GF, Mil EG, Vreugdenhil AC, Winkens B, Nederkoorn C, et al. Bariatric surgery in adolescents: a prospective randomized controlled trial comparing laparoscopic gastric banding to combined lifestyle interventions in adolescents with severe obesity (BASIC trial). BMC Pediatrics 2019;19(1):34. [DOI: 10.1186/s12887-019-1395-9] - DOI - PMC - PubMed
NCT02378259 {published data only}
    1. Janson A, Järvholm K, Gronowitz E, Sjögren L, Klaesson S, Engström M, et al. A randomized controlled trial comparing intensive non-surgical treatment with bariatric surgery in adolescents aged 13-16 years (AMOS2): Rationale, study design, and patient recruitment. Contemporary Clinical Trials Communications 2020;27(19):100592. [DOI: 10.1016/j.conctc.2020.100592] - DOI - PMC - PubMed

Additional references

Al‐Khudairy 2017
    1. Al-Khudairy L, Loveman E, Colquitt JL, Mead E, Johnson RE, Fraser H, et al. Diet, physical activity and behavioural interventions for the treatment of overweight or obese adolescents aged 12 to 17 years. Cochrane Database of Systematic Reviews 2017;6(6):Cd012691. - PMC - PubMed
Alqahtani 2021
    1. Alqahtani AR, Elahmedi M, Abdurabu HY, Alqahtani S. Ten-year outcomes of children and adolescents who underwent sleeve gastrectomy: weight loss, comorbidity resolution, adverse events, and growth velocity. Journal of the American College of Surgeons 2021;233(6):657-64. - PubMed
Anvari 2021
    1. Anvari S, Samarasinghe Y, Alotaiby N, Tiboni M, Crowther M, Doumouras AG. Iron supplementation following bariatric surgery: a systematic review of current strategies. Obesity Reviews 2021;22(9):e13268. - PubMed
Arditi 2016
    1. Arditi C, Burnand B, Peytremann-Bridevaux I. Adding non-randomised studies to a Cochrane review brings complementary information for healthcare stakeholders: an augmented systematic review and meta-analysis. BMC Health Services Research 2016;16(1):598. - PMC - PubMed
Armstrong 2019
    1. Armstrong SC, Bolling CF, Michalsky MP, Reichard KW. Pediatric metabolic and bariatric surgery: evidence, barriers, and best practices. Pediatrics 2019;144(6):e20193223. - PubMed
Arterburn 2020
    1. Arterburn DE, Telem DA, Kushner RF, Courcoulas AP. Benefits and risks of bariatric surgery in adults: a review. Journal of the American Medical Association 2020;324(9):879-87. - PubMed
Barrett 2020
    1. Barrett T, Jalaludin MY, Turan S, Hafez M, Shehadeh N. Rapid progression of type 2 diabetes and related complications in children and young people - a literature review. Pediatric Diabetes 2020;21(2):158-72. - PMC - PubMed
Bendor 2020
    1. Bendor CD, Bardugo A, Pinhas-Hamiel O, Afek A, Twig G. Cardiovascular morbidity, diabetes and cancer risk among children and adolescents with severe obesity. Cardiovascular Diabetology 2020;19(1):79. - PMC - PubMed
Benedix 2017
    1. Benedix F, Krause T, Adolf D, Wolff S, Lippert H, Manger T, et al. Perioperative course, weight loss and resolution of comorbidities after primary sleeve gastrectomy for morbid obesity: are there differences between adolescents and adults? Obesity Surgery 2017;27(9):2388-97. - PubMed
Bjerregaard 2018
    1. Bjerregaard LG, Jensen BW, Ängquist L, Osler M, Sørensen TIA, Baker JL. Change in overweight from childhood to early adulthood and risk of type 2 diabetes. New England Journal of Medicine 2018;378(14):1302-12. - PubMed
Bridger 2021
    1. Bridger Staatz C, Kelly Y, Lacey RE, Blodgett JM, George A, Arnot M, et al. Socioeconomic position and body composition in childhood in high- and middle-income countries: a systematic review and narrative synthesis. International Journal of Obesity 2021;45(11):2316-34. - PMC - PubMed
Bryant 2014
    1. Bryant M, Ashton L, Nixon J, Jebb S, Wright J, Roberts K, et al. Framework of outcome measures recommended for use in the evaluation of childhood obesity treatment interventions: the CoOR framework. Pediatric Obesity 2014;9(6):e116-31. - PubMed
Buoncristiano 2021
    1. Buoncristiano M, Williams J, Simmonds P, Nurk E, Ahrens W, Nardone P, et al. Socioeconomic inequalities in overweight and obesity among 6- to 9-year-old children in 24 countries from the World Health Organization European region. Obesity Reviews 2021;22(Suppl 6):e13213. - PubMed
Carlsson 2020
    1. Carlsson LM, Sjöholm K, Jacobson P, Andersson-Assarsson JC, Svensson PA, Taube M, et al. Life expectancy after bariatric surgery in the Swedish obese subjects study. New England Journal of Medicine 2020;383(16):1535-43. - PMC - PubMed
Chung 2018
    1. Chung ST, Onuzuruike AU, Magge SN. Cardiometabolic risk in obese children. Annals of the New York Academy of Sciences 2018;1411(1):166-83. - PMC - PubMed
Cochrane 2022
    1. Cochrane. How CENTRAL is created. www.cochranelibrary.com/central/central-creation (accessed 15 June 2022).
Cole 2012
    1. Cole TJ, Lobstein T. Extended international (IOTF) body mass index cut-offs for thinness, overweight and obesity. Pediatric Obesity 2012;7(4):284-94. - PubMed
Colquitt 2016
    1. Colquitt JL, Loveman E, O'Malley C, Azevedo LB, Mead E, Al-Khudairy L, et al. Diet, physical activity, and behavioural interventions for the treatment of overweight or obesity in preschool children up to the age of 6 years. Cochrane Database of Systematic Reviews 2016, Issue 3. Art. No: CD012691. [DOI: 10.1002/14651858.CD012691] - DOI - PMC - PubMed
DAG 2019
    1. Deutsche Adipositas-Gesellschaft. Treatment and prevention of obesity in childhood and adolescence [Therapie und Prävention der Adipositas im Kindes- und Jugendalter]. AWMF-Nr. 050-002 August 2019.
de Onis 2007
    1. Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bulletin of the World Health Organization 2007;85(9):660-7. - PMC - PubMed
de Wilde 2018
    1. Wilde JA, Meeuwsen RC, Middelkoop BJ. Growing ethnic disparities in prevalence of overweight and obesity in children 2-15 years in the Netherlands. European Journal of Public Health 2018;28(6):1023-8. - PubMed
Dinsa 2012
    1. Dinsa GD, Goryakin Y, Fumagalli E, Suhrcke M. Obesity and socioeconomic status in developing countries: a systematic review. Obesity Reviews 2012;13(11):1067-79. - PMC - PubMed
Ells 2018
    1. Ells LJ, Rees K, Brown T, Mead E, Al-Khudairy L, Azevedo L, et al. Interventions for treating children and adolescents with overweight and obesity: an overview of Cochrane reviews. International Journal of Obesity 2018;42(11):1823-33. - PubMed
Farpour‐Lambert 2015
    1. Farpour-Lambert NJ, Baker JL, Hassapidou M, Holm JC, Nowicka P, O'Malley G, et al. Childhood obesity is a chronic disease demanding specific health care - a position statement from the Childhood Obesity Task Force (COTF) of the European Association for the Study of Obesity (EASO). Obesity Facts 2015;8(5):342-9. - PMC - PubMed
Fryar 2020
    1. Fryar CD, Carroll MD, Afful J. Prevalence of overweight, obesity, and severe obesity among children and adolescents aged 2–19 years: United States, 1963–1965 through 2017–2018; December 2020. NCHS Health E-Stats. Available from www.cdc.gov/nchs/data/hestat/obesity-child-17-18/obesity-child.htm.
Gantz 2022
    1. Gantz MG, Driscoll DJ, Miller JL, Duis JB, Butler MG, Gourash L, et al. Critical review of bariatric surgical outcomes in patients with Prader-Willi syndrome and other hyperphagic disorders. Obesity (Silver Spring) 2022;30(5):973-81. - PubMed
Gerstein 2019
    1. Gerstein HC, McMurray J, Holman RR. Real-world studies no substitute for RCTs in establishing efficacy. Lancet 2019;393(10168):210-1. - PubMed
Gibb 2019
    1. Gibb S, Shackleton N, Audas R, Taylor B, Swinburn B, Zhu T, et al. Child obesity prevalence across communities in New Zealand: 2010-2016. Australian and New Zealand Journal of Public Health 2019;43(2):176-81. - PubMed
GRADEpro GDT [Computer program]
    1. GRADEpro GDT. Version accessed 7 September 2022. Hamilton (ON): McMaster University (developed by Evidence Prime). Available at gradepro.org.
Griggs 2018
    1. Griggs CL, Perez NP Jr, Goldstone RN, Kelleher CM, Chang DC, Stanford FC, et al. National trends in the use of metabolic and bariatric surgery among pediatric patients with severe obesity. JAMA Pediatrics 2018;172(12):1191-2. - PMC - PubMed
Ha 2021
    1. Ha J, Kwon Y, Kwon JW, Kim D, Park SH, Hwang J, et al. Micronutrient status in bariatric surgery patients receiving postoperative supplementation per guidelines: insights from a systematic review and meta-analysis of longitudinal studies. Obesity Reviews 2021;22(7):e13249. - PubMed
Henfridsson 2019
    1. Henfridsson P, Laurenius A, Wallengren O, Beamish AJ, Dahlgren J, Flodmark CE, et al. Micronutrient intake and biochemistry in adolescents adherent or nonadherent to supplements 5 years after Roux-en-Y gastric bypass surgery. Surgery for Obesity and Related Diseases 2019;15(9):1494-502. - PubMed
Higgins 2002
    1. Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Statistics in Medicine 2002;21(11):1539-58. - PubMed
Higgins 2003
    1. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analysis. BMJ 2003;327(7414):557-60. - PMC - PubMed
Higgins 2009
    1. Higgins JP, Thompson SG, Spiegelhalter DJ. A re-evaluation of random-effects meta-analysis. Journal of the Royal Statistical Society: Series A (Statistics in Society) 2009;172(1):137-59. - PMC - PubMed
Higgins 2022a
    1. Higgins JP, Savović J, Page MJ, Elbers RG, Sterne JA. Chapter 8: Assessing risk of bias in a randomized trial. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA, editor(s). Cochrane Handbook for Systematic Reviews of Interventions version 6.3 (updated February 2022). Cochrane, 2022. Available from www.training.cochrane.org/handbook.
Higgins 2022b
    1. Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA, editor(s). Cochrane Handbook for Systematic Reviews of Interventions version 6.3 (updated February 2022). Cochrane, 2022. Available from www.training.cochrane.org/handbook.
Inge 2019
    1. Inge TH, Courcoulas AP, Jenkins TM, Michalsky MP, Brandt ML, Xanthakos SA, et al. Five-year outcomes of gastric bypass in adolescents as compared with adults. New England Journal of Medicine 2019;380(22):2136-45. - PMC - PubMed
Jarnig 2022
    1. Jarnig G, Jaunig J, Kerbl R, Strenger V, Haeusler G, Poppel MN. Acceleration in BMI gain following COVID-19 restrictions. A longitudinal study with 7- to 10-year-old primary school children. Pediatric Obesity 2022;17(6):e12890. - PMC - PubMed
Kelly 2018
    1. Kelly AS, Marcus MD, Yanovski JA, Yanovski SZ, Osganian SK. Working toward precision medicine approaches to treat severe obesity in adolescents: report of an NIH workshop. International Journal of Obesity 2018;42(11):1834-44. - PMC - PubMed
Knai 2012
    1. Knai C, Lobstein T, Darmon N, Rutter H, McKee M. Socioeconomic patterning of childhood overweight status in Europe. International Journal of Environmental Research and Public Health 2012;9(4):1472-89. - PMC - PubMed
Krebs 2007
    1. Krebs NF, Himes JH, Jacobson D, Nicklas TA, Guilday P, Styne D. Assessment of child and adolescent overweight and obesity. Pediatrics 2007;120(Suppl 4):S193-228. - PubMed
Kuczmarski 2002
    1. Kuczmarski RJ, Ogden CL, Guo SS, Grummer-Strawn LM, Flegal KM, Mei Z, et al. 2000 CDC growth charts for the United States: methods and development. Vital and health statistics. Series 11, Data from the National Health Survey 2002;May(246):1-190. - PubMed
Lange 2021
    1. Lange SJ, Kompaniyets L, Freedman DS, Kraus EM, Porter R, Blanck HM, et al. Longitudinal trends in body mass index before and during the COVID-19 pandemic among persons aged 2-19 years - United States, 2018-2020. MMWR. Morbidity and mortality weekly report 2021;70(37):1278-83. - PMC - PubMed
Leclercq 2013
    1. Leclercq E, Leeflang MM, Dalen EC, Kremer LC. Validation of search filters for identifying pediatric studies in PubMed. Journal of Pediatrics 2013;162(3):629-34. - PubMed
Lefebvre 2011
    1. Lefebvre C, Manheimer E, Glanville J. Chapter 6: Searching for studies. In: Higgins JP, Green S, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from training.cochrane.org/handbook/archive/v5.1/.
Lennerz 2014
    1. Lennerz BS, Wabitsch M, Lippert H, Wolff S, Knoll C, Weiner R, et al. Bariatric surgery in adolescents and young adults--safety and effectiveness in a cohort of 345 patients. International Journal of Obesity 2014;38(3):334-40. - PubMed
Li 2021
    1. Li MK, Sathiyamoorthy T, Regina A, Strom M, Toulany A, Hamilton J. "Your own pace, your own path": perspectives of adolescents navigating life after bariatric surgery. International Journal of Obesity 2021;45(12):2546-53. - PMC - PubMed
Lindberg 2020
    1. Lindberg L, Danielsson P, Persson M, Marcus C, Hagman E. Association of childhood obesity with risk of early all-cause and cause-specific mortality: a Swedish prospective cohort study. PLoS Med 2020;17(3):e1003078. - PMC - PubMed
Loveman 2015
    1. Loveman E, Al-Khudairy L, Johnson RE, Robertson W, Colquitt JL, Mead EL, et al. Parent-only interventions for childhood overweight or obesity in children aged 5 to 11 years. Cochrane Database of Systematic Reviews 2015, Issue 12. Art. No: CD012008. [DOI: 10.1002/14651858.CD012008] - DOI - PMC - PubMed
Luca 2015
    1. Luca P, Dettmer E, Khoury M, Grewal P, Manlhiot C, McCrindle BW, et al. Adolescents with severe obesity: outcomes of participation in an intensive obesity management programme. Pediatric Obesity 2015;10(4):275-82. - PubMed
Mead 2016
    1. Mead E, Atkinson G, Richter B, Metzendorf MI, Baur L, Finer N, et al. Drug interventions for the treatment of obesity in children and adolescents. Cochrane Database of Systematic Reviews 2016, Issue 11. Art. No: CD012436. [DOI: 10.1002/14651858.CD012436] - DOI - PMC - PubMed
Mead 2017
    1. Mead E, Brown T, Rees K, Azevedo LB, Whittaker V, Jones D, et al. Diet, physical activity and behavioural interventions for the treatment of overweight or obese children from the age of 6 to 11 years. Cochrane Database of Systematic Reviews 2017, Issue 6. Art. No: CD012651. [DOI: 10.1002/14651858.CD012651] - DOI - PMC - PubMed
Meyer 2021
    1. Meyer JF, Larsen SB, Blond K, Damsgaard CT, Bjerregaard LG, Baker JL. Associations between body mass index and height during childhood and adolescence and the risk of coronary heart disease in adulthood: A systematic review and meta-analysis. Obesity Reviews 2021;22(9):e13276. - PubMed
Michalsky 2015
    1. Michalsky MP, Inge TH, Simmons M, Jenkins TM, Buncher R, Helmrath M, et al. Cardiovascular risk factors in severely obese adolescents: the Teen Longitudinal Assessment of Bariatric Surgery (Teen-LABS) study. JAMA Pediatrics 2015;169(5):438-44. - PMC - PubMed
Min 2018
    1. Min J, Wen X, Xue H, Wang Y. Ethnic disparities in childhood BMI trajectories and obesity and potential causes among 29,250 US children: findings from the Early Childhood Longitudinal Study-Birth and Kindergarten Cohorts. International Journal of Obesity 2018;42(9):1661-70. - PubMed
Moustgaard 2020
    1. Moustgaard H, Clayton GL, Jones HE, Boutron I, Jørgensen L, Laursen DR, et al. Impact of blinding on estimated treatment effects in randomised clinical trials: meta-epidemiological study. BMJ 2020;368:l6802. - PMC - PubMed
NCD‐RisC 2017
    1. NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet 2017;390(10113):2627-42. - PMC - PubMed
Nguyen 2017
    1. Nguyen NT, Varela JE. Bariatric surgery for obesity and metabolic disorders: state of the art. Nature Reviews Gastroenterology & Hepatology 2017;14(3):160-9. - PubMed
Nobili 2015
    1. Nobili V, Vajro P, Dezsofi A, Fischler B, Hadzic N, Jahnel J, et al. Indications and limitations of bariatric intervention in severely obese children and adolescents with and without nonalcoholic steatohepatitis: ESPGHAN Hepatology Committee Position Statement. Journal of Pediatric Gastroenterology and Nutrition 2015;60(4):550-61. - PubMed
Nordin 2018
    1. Nordin K, Brorsson AL, Ekbom K. Adolescents' experiences of obesity surgery: a qualitative study. Surgery for Obesity and Related Diseases 2018;14(8):1157-62. [DOI: 10.1016/j.soard.2018.04.003] - DOI - PubMed
Nuotio 2022
    1. Nuotio J, Laitinen TT, Sinaiko AR, Woo JG, Urbina EM, Jacobs DR Jr, et al. Obesity during childhood is associated with higher cancer mortality rate during adulthood: the i3C Consortium. International Journal of Obesity 2022;46(2):393-9. - PMC - PubMed
Ogden 2018
    1. Ogden CL, Fryar CD, Hales CM, Carroll MD, Aoki Y, Freedman DS. Differences in obesity prevalence by demographics and urbanization in US children and adolescents, 2013-2016. JAMA 2018;319(23):2410-8. - PMC - PubMed
Page 2021
    1. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;29(372):n71. [DOI: 10.1136/bmj.n71] - DOI - PMC - PubMed
Pedersen 2016
    1. Pedersen DC, Aarestrup J, Pearson S, Baker JL. Ethnic inequalities in overweight and obesity prevalence among Copenhagen schoolchildren from 2002 to 2007. Obesity Facts 2016;9(4):284-95. - PMC - PubMed
Peña 2017
    1. Peña AS, Delko T, Couper R, Sutton K, Kritas S, Omari T, et al. Laparoscopic adjustable gastric banding in Australian adolescents: should it be done? Obesity Surgery 2017;27(7):1667-73. - PubMed
Phillips 2018
    1. Phillips BT, Shikora SA. The history of metabolic and bariatric surgery: development of standards for patient safety and efficacy. Metabolism 2018;79:97-107. - PubMed
Pinhas‐Hamiel 2020
    1. Pinhas-Hamiel O, Reichman B, Afek A, Derazne E, Tzur D, Hamiel U, et al. Socioeconomic inequalities and severe obesity-sex differences in a nationwide study of 1.12 million Israeli adolescents. Pediatric Obesity 2020;15(12):e12681. - PubMed
Pinhas‐Hamiel 2022
    1. Pinhas-Hamiel O, Hamiel U, Bendor CD, Bardugo A, Twig G, Cukierman-Yaffe T. The global spread of severe obesity in toddlers, children, and adolescents: a systematic review and meta-analysis. Obesity Facts 2022;15(2):118-34. - PMC - PubMed
Pourcher 2015
    1. Pourcher G, De Filippo G, Ferretti S, Piquard C, Dagher I, Bougnères P. Short-term results of single-port sleeve gastrectomy in adolescents with severe obesity. Surgery for Obesity and Related Diseases 2015;11(1):65-9. [DOI: 10.1016/j.soard.2014.05.029] - DOI - PubMed
Pratt 2018
    1. Pratt JS, Browne A, Browne NT, Bruzoni M, Cohen M, Desai A, et al. ASMBS pediatric metabolic and bariatric surgery guidelines, 2018. Surgery for Obesity and Related Diseases 2018;14(7):882-901. - PMC - PubMed
Puhl 2020
    1. Puhl RM, Himmelstein MS, Pearl RL. Weight stigma as a psychosocial contributor to obesity. American Psychologist 2020 Feb-Mar;75(2):274-89. [DOI: 10.1037/amp0000538] - DOI - PubMed
Qi 2017
    1. Qi L, Guo Y, Liu CQ, Huang ZP, Sheng Y, Zou DJ. Effects of bariatric surgery on glycemic and lipid metabolism, surgical complication and quality of life in adolescents with obesity: a systematic review and meta-analysis. Surgery for Obesity and Related Diseases 2017;13(12):2037-55. - PubMed
Riley 2011
    1. Riley RD, Higgins JP, Deeks JJ. Interpretation of random effects meta-analyses. BMJ 2011;342:d549. - PubMed
Rives‐Lange 2022
    1. Rives-Lange C, Rassy N, Carette C, Phan A, Barsamian C, Thereaux J, et al. Seventy years of bariatric surgery: a systematic mapping review of randomized controlled trials. Obesity Reviews 2022 May;23(5):e13420. [DOI: 10.1111/obr.13420] - DOI - PubMed
Rosen 2006
    1. Rosen L, Manor O, Engelhard D, Zucker D. In defense of the randomized controlled trial for health promotion research. American Journal of Public Health 2006;96(7):1181-6. - PMC - PubMed
Ruiz‐Cota 2019
    1. Ruiz-Cota P, Bacardí-Gascón M, Jiménez-Cruz A. Long-term outcomes of metabolic and bariatric surgery in adolescents with severe obesity with a follow-up of at least 5 years: a systematic review. Surgery for Obesity and Related Diseases 2019;15(1):133-44. - PubMed
Ryder 2020
    1. Ryder JR, Northrop E, Rudser KD, Kelly AS, Gao Z, Khoury PR, et al. Accelerated early vascular aging among adolescents with obesity and/or type 2 diabetes mellitus. Journal of the American Heart Association 2020;9(10):e014891. - PMC - PubMed
Santesso 2016
    1. Santesso N, Carrasco-Labra A, Langendam M, Brignardello-Petersen R, Mustafa RA, Heus P, et al. Improving GRADE evidence tables part 3: detailed guidance for explanatory footnotes supports creating and understanding GRADE certainty in the evidence judgments. Journal of Clinical Epidemiology 2016;74:28-39. [PMID: ] - PubMed
Santesso 2020
    1. Santesso N, Glenton C, Dahm P, Garner P, Akl EA, Alper B, et al. GRADE guidelines 26: informative statements to communicate the findings of systematic reviews of interventions. Journal of Clinical Epidemiology 2020;119:126-35. [PMID: ] - PubMed
Schauer 2015
    1. Schauer DP, Arterburn DE, Livingston EH, Coleman KJ, Sidney S, Fisher D, et al. Impact of bariatric surgery on life expectancy in severely obese patients with diabetes: a decision analysis. Annals of Surgery 2015;261(5):914-9. - PMC - PubMed
Schünemann 2022
    1. Schünemann HJ, Higgins JPT, Vist GE, Glasziou P, Akl EA, Skoetz N, et al. Chapter 14: Completing ‘Summary of findings’ tables and grading the certainty of the evidence. In Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA, editor(s), Cochrane Handbook for Systematic Reviews of Interventions version 6.3 (updated February 2022). Cochrane, 2021. Available from www.training.cochrane.org/handbook.
Schwingshackl 2022
    1. Schwingshackl L, Nagavci B, Stadelmaier J, Werner SS, Cuello Garcia CA, Schünemann HJ, et al. Pooling of cohort studies and RCTs affects GRADE certainty of evidence in nutrition research. Journal of Clinical Epidemiology 2022;147:151-9. - PubMed
Selvendran 2018
    1. Selvendran SS, Penney NC, Aggarwal N, Darzi AW, Purkayastha S. Treatment of obesity in young people-a systematic review and meta-analysis. Obesity Surgery 2018;28(8):2537-49. - PubMed
Sharma 2019
    1. Sharma V, Coleman S, Nixon J, Sharples L, Hamilton-Shield J, Rutter H, et al. A systematic review and meta-analysis estimating the population prevalence of comorbidities in children and adolescents aged 5 to 18 years. Obesity Reviews 2019;20(10):1341-9. - PMC - PubMed
Shoar 2017
    1. Shoar S, Mahmoudzadeh H, Naderan M, Bagheri-Hariri S, Wong C, Parizi AS, et al. Long-term outcome of bariatric surgery in morbidly obese adolescents: a systematic review and meta-analysis of 950 patients with a minimum of 3 years follow-up. Obesity Surgery 2017;27(12):3110-7. - PubMed
Shrewsbury 2008
    1. Shrewsbury V, Wardle J. Socioeconomic status and adiposity in childhood: a systematic review of cross-sectional studies 1990-2005. Obesity 2008;16(2):275-84. - PubMed
Skinner 2015
    1. Skinner AC, Perrin EM, Moss LA, Skelton JA. Cardiometabolic risks and severity of obesity in children and young adults. New England Journal of Medicine 2015;373(14):1307-17. - PubMed
Speich 2022
    1. Speich B, Gryaznov D, Busse JW, Gloy VL, Lohner S, Klatte K, et al. Nonregistration, discontinuation, and nonpublication of randomized trials: a repeated metaresearch analysis. PLOS Medicine 2022;19(4):e1003980. - PMC - PubMed
Spinelli 2019
    1. Spinelli A, Buoncristiano M, Kovacs VA, Yngve A, Spiroski I, Obreja G, et al. Prevalence of severe obesity among primary school children in 21 European countries. Obesity Facts 2019;12(2):244-58. - PMC - PubMed
Sterne 2011
    1. Sterne JA, Sutton AJ, Ioannidis JP, Terrin N, Jones DR, Lau J, et al. Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials. BMJ 2011;343:d4002. - PubMed
Sterne 2019
    1. Sterne JA, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ 2019;366:l4898. - PubMed
Strugnell 2020
    1. Strugnell C, Mathrani S, Sollars L, Swinburn B, Copley V. Variation in the socioeconomic gradient of obesity by ethnicity - England's National Child Measurement Programme. Obesity 2020;28(10):1951-63. - PMC - PubMed
Styne 2017
    1. Styne DM, Arslanian SA, Connor EL, Farooqi IS, Murad MH, Silverstein JH, et al. Pediatric obesity-assessment, treatment, and prevention: an Endocrine Society clinical practice guideline. Journal of Clinical Endocrinology and Metabolism 2017;102(3):709-57. - PMC - PubMed
Trooboff 2019
    1. Trooboff SW, Stucke RS, Riblet NB, Kulkarni AS, Anand R, Casey A, et al. Psychosocial outcomes following adolescent metabolic and bariatric surgery: a systematic review and meta-analysis. Obesity Surgery 2019;29(11):3653-64. - PubMed
Twig 2016
    1. Twig G, Yaniv G, Levine H, Leiba A, Goldberger N, Derazne E, et al. Body-mass index in 2.3 million adolescents and cardiovascular death in adulthood. New England Journal of Medicine 2016;374(25):2430-40. - PubMed
van de Pas 2021
    1. de Pas KG, Bonouvrie DS, Janssen L, Roebroek YG, Zegers BS, Leclercq WK, et al. Bariatric surgery in youth: the perspective of dutch pediatricians, parents, and adolescents. Obesity Surgery 2021;31(11):4821-8. [DOI: 10.1007/s11695-021-05648-8] - DOI - PMC - PubMed
van der Baan‐Slootweg 2014
    1. Baan-Slootweg O, Benninga MA, Beelen A, Palen J, Tamminga-Smeulders C, Tijssen JG, et al. Inpatient treatment of children and adolescents with severe obesity in the Netherlands: a randomized clinical trial. JAMA Pediatrics 2014;168(9):807-14. - PubMed
Vogel 2022
    1. Vogel M, Geserick M, Gausche R, Beger C, Poulain T, Meigen C, et al. Age- and weight group-specific weight gain patterns in children and adolescents during the 15 years before and during the COVID-19 pandemic. International Journal of Obesity 2022;46(1):144-52. - PMC - PubMed
Wang 2012
    1. Wang Y, Lim H. The global childhood obesity epidemic and the association between socio-economic status and childhood obesity. International Review of Psychiatry 2012;24(3):176-88. - PMC - PubMed
Ward 2017
    1. Ward ZJ, Long MW, Resch SC, Giles CM, Cradock AL, Gortmaker SL. Simulation of growth trajectories of childhood obesity into adulthood. New England Journal of Medicine 2017;377(22):2145-53. - PMC - PubMed
Weihrauch‐Blüher 2019
    1. Weihrauch-Blüher S, Schwarz P, Klusmann JH. Childhood obesity: increased risk for cardiometabolic disease and cancer in adulthood. Metabolism 2019;92:147-52. - PubMed
WHO 2000
    1. World Health Organization. Obesity: preventing and managing the global epidemic: report of a WHO consultation; 2000. Available from apps.who.int/iris/handle/10665/42330. - PubMed
Wood 2008
    1. Wood L, Egger M, Gluud LL, Schulz KF, Juni P, Altman DG, et al. Empirical evidence of bias in treatment effect estimates in controlled trials with different interventions and outcomes: meta-epidemiological study. BMJ 2008;336(7644):601-5. - PMC - PubMed
Xu 2021
    1. Xu G, Song M. Recent advances in the mechanisms underlying the beneficial effects of bariatric and metabolic surgery. Surgery for Obesity and Related Diseases 2021;17(1):231-8. - PMC - PubMed
Yang 2022
    1. Yang D, Luo C, Feng X, Qi W, Qu S, Zhou Y, et al. Changes in obesity and lifestyle behaviours during the COVID-19 pandemic in Chinese adolescents: a longitudinal analysis from 2019 to 2020. Pediatric Obesity 2022;17(5):e12874. - PMC - PubMed

References to other published versions of this review

Ells 2015
    1. Ells L J, Mead E, Atkinson G, Corpeleijn E, Roberts K, Viner R, et al. Surgery for the treatment of obesity in children and adolescents. Cochrane Database of Systematic Reviews 2015, Issue 6. Art. No: CD011740. [DOI: 10.1002/14651858.CD011740] - DOI - PubMed
Oude Luttikhuis 2009
    1. Oude Luttikhuis H, Baur L, Jansen H, Shrewbury VA, O’Malley C, Stolk RP, et al. Interventions for treating obesity in children. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No: CD001872. [DOI: 10.1002/14651858.CD001872.pub2] - DOI - PubMed
Summerbell 2003
    1. Summerbell CD, Ashton V, Campbell KJ, Edmunds L, Kelly S, Waters E. Interventions for treating obesity in children. Cochrane Database of Systematic Reviews 2003, Issue 3. Art. No: CD001872. [DOI: 10.1002/14651858.CD001872] - DOI - PubMed

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