Comorbidities that are “more or less reversible” with bariatric surgery in adolescents and are the most common indications for surgery are diabetes, sleep apnea, and nonalcoholic steatohepatitis. Others in this category include hypertension, pseudotumor cerebri, gastro-esophageal reflux disease, asthma, and poor self-esteem, said Dr. Janey S.A. Pratt, a bariatric surgeon at Massachusetts General Hospital in Boston. However, she noted, other obesity-linked conditions are generally not reversible, including glomerulosclerosis of the kidney, gallstones, flat feet, major orthopedic deformities, precocious puberty, and some body-image issues.
“The most important reason to operate on obese adolescents is … to treat or prevent the comorbidities associated with excess weight,” Dr. Pratt said. “Will all of the adolescents we operate on be obese as adults?” Dr. Pratt cited results from a recent study in which 100% of children with a BMI above the 99th percentile after age 10 years had BMIs greater than 35 kg/m
Disclosures: Dr. Inge has received research funding from Ethicon Inc. Dr. Pratt has served as a consultant to Covidien. Dr. Nadler received research support from Allergan. Dr. Holterman and Dr. Michalsky had no financial disclosures.
'There may be a window of opportunity to act before there is more permanent damage to the heart.'
Source DR. INGE
'The most important reason to operate on obese adolescents is … to treat or prevent the comorbidities.'
Source DR. PRATT
'It's a new concept to think of surgery as preventive medicine, but it is preventive.'
Source DR. HOLTERMAN