Pediatrics Group Offers Guidance on Bariatric Surgery for Adolescents

By Kelly Young

Edited by Susan Sadoughi, MD, and André Sofair, MD, MPH

The American Academy of Pediatrics has published new advice for treating adolescents who are eligible for bariatric surgery in Pediatrics. Among them:

• Clinicians should recognize that severe obesity is considered a high-risk condition that likely won't resolve with only medication or lifestyle modification.

• The following adolescents may be eligible for surgery: patients with class 2 obesity (BMI, at least 35 or 120% of the 95th percentile for age and sex) plus clinically significant disease (e.g., obstructive sleep apnea, type 2 diabetes, hypertension) or class 3 obesity (BMI, at least 40 or 140% of the 95th percentile). No lower age limit for bariatric surgery is included.

• Pediatricians should refer eligible patients for surgery. Current referral rates are low, as is insurance coverage for this group.

• Evidence doesn't suggest that watchful waiting is an effective strategy. When surgery is done earlier, outcomes are generally better and adverse events are lower.