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Review
. 2023 Aug 18;108(9):2184-2192.
doi: 10.1210/clinem/dgad155.

Long-term Outcomes Following Adolescent Metabolic and Bariatric Surgery

Andrew J Beamish  1   2 , Elizabeth Ryan Harper  3 , Kajsa Järvholm  4   5 , Annika Janson  6   7 , Torsten Olbers  5   8
Affiliations
Review

Long-term Outcomes Following Adolescent Metabolic and Bariatric Surgery

Andrew J Beamish et al. J Clin Endocrinol Metab. .

Abstract

Severe obesity in adolescence negatively impacts upon health and wellbeing. Lifestyle modifications do not usually achieve a sufficient degree or durability of weight loss to mitigate the risk of medical complications. In recent years, metabolic and bariatric surgery (MBS), already a well-established treatment for adults with severe obesity, has emerged as an option in adolescents. Controlled studies in this age group have demonstrated substantial and sustained weight loss, improvements in associated health parameters, and a safety profile surpassing that observed in adult patients. This review aims to present published data on the results of MBS in adolescents with a focus on long-term outcomes. Indications for bariatric surgery and aspects of timing in the young person's life are also presented, along with safety considerations and factors influencing patient selection for surgery. We conclude, predominantly from short- to medium-term outcomes data, that MBS is a safe and valuable therapeutic option for adolescents with severe obesity. Considering the poor health and social wellbeing prognosis in this group, MBS appears to be underutilized. The need for continued research, multiprofessional specialist provision, coherent contemporary clinical guidelines, and routine long-term follow-up in adolescents undergoing MBS is highlighted.

Keywords: adolescents; bariatric surgery; children; guidelines; metabolic and bariatric surgery; obesity.

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Figures

Figure 1.
Figure 1.
Metabolic and bariatric surgical procedures. (A) Roux-en-Y gastric bypass (RYGB), (B) sleeve gastrectomy (SG), and (C) adjustable gastric band.
Figure 2.
Figure 2.
Change in BMI in in studies reporting outcomes to medium to long-term outcomes after adolescent metabolic and bariatric surgery (7, 8, 22, 46, 47). AMOS, Adolescent Morbid Obesity Surgery study; RYGB, Roux-en-Y gastric bypass; FABS-5+, Follow-up of Adolescent Bariatric Surgery after 5+ years study; Teen-LABS, Teen-Longitudinal Adolescent Bariatric Surgery study; SG, sleeve gastrectomy.
See this image and copyright information in PMC

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