By: Janda Morgan April 10, 2008 Advisor: Dr Weaver Review background & statistical evidence related to childhood/adolescent obesity. Review the use of bariatric surgery in adolescents. Recommendations/conclusions regarding bariatric surgery in obese adolescents.
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April 10, 2008
Advisor: Dr Weaver
Review background & statistical evidence related to childhood/adolescent obesity.
The literature varies slightly as far as the number of children/teens who are considered to be overweight/obese; however all agree that childhood obesity has dramatically increased over the past few decades.
Evidence indicates that the prevalence of childhood obesity is greater in the southern states.
If childhood obesity trends continue the average life expectancy maybe reduced by as much as 2-5 years.
Bariatric surgery is a major procedure that involves multiple risks and life- long post-operation implications that must be considered.
The patients should have a documented attempt of at least six months of an organized weight-loss program without success.
Individuals with a medically correctable cause of obesity are not candidates for surgery.
Patients who undergo these procedures may suffer malnutrition and various metabolic consequences, and as a result they must comply with lifelong use of vitamin and mineral supplements.
During surgery- hemorrhage, problems with anesthesia, and bowel perforation.
This study showed one year post operative improvement in lab values and anthropometric data, including: BMI, TG, TC, LDL, & BG.
This study reviewed 51 adolescents who had lap-band procedure. The results showed a mean weight loss of 42 percent of excess weight at 6 months post-op and 67 percent loss of excess weight at 18 months post-op. The study reported no mortality or other major post-op complications. The post-operative improvements include cure of diabetes or hypertension, improvement of other comorbidities, and over-all improvement of well-being. Lap banding also has the benefit of not changing the anatomy of the digestive system and the procedure is adjustable, as well as reversible if necessary. The use of laparoscopic procedures for weight loss in adolescents is promising for the future and may avoid some of the challenges associated with gastric bypass.
Address the causes of childhood obesity, including increased caloric intake and decreased physical activity.
Surgery should only be performed on individuals who meet the specific criteria outlined in this presentation.
Al-Qahtani AR. Laparoscopic adjustable gastric banding in adolescent: safety and efficacy. Journal of Pediatric Surgery. 2007; 42:894-897.
Singhal V, Schwenk WF, Seema K. Evaluation and management of childhood and adolescent obesity. Mayo Clin Proc. 2007; 82: 1258-1264