Rates of teens undergoing bariatric surgery have grown, but the procedure still is underutilized, especially among Hispanic and Black youths, according to a new study.
“It is imperative that healthcare providers work with families, especially the most vulnerable and high-risk, to expand equitable access to comprehensive, multi-disciplinary, pediatric-specific bariatric programs,” researchers from Washington University wrote in “National Trends in Pediatric Metabolic & Bariatric Surgery: 2010-2017,” (Steinberger AE, et al. Pediatrics. Nov. 14, 2022).
The team analyzed data from a large inpatient health care database, looking at metabolic and bariatric surgery (MBS) among adolescents ages 12-19 years from 2010-’17.
Annual rates of these procedures rose from 2.29 to 4.62 per 100,000 adolescents at a time when about 19.3% had obesity. The mean age hovered at about 18 years during the study period, and about three-quarters were female.
Rates for Black and Hispanic youths lagged those of White teens, despite studies showing the prevalence of obesity is higher in Hispanic and Black youths (25.6% and 24.2%, respectively) than White youths (16.1%). White teens made up 54% to 45% of the patients, while those who were Black fell from 18% to 15%. Hispanic teens undergoing bariatric surgery rose from 17% to 26%. Just over half of patients were privately insured. Those with Medicaid or Medicare rose from 25% to 36%.
About 16% of the adolescents undergoing surgery had a body mass index over 50 in the later years of the study, up from 4%. Obesity-related comorbidities did not change drastically. The most common were hypertension and obstructive sleep apnea.
Most procedures were performed at adult hospitals, and there was a shift to minimally invasive procedures like laparoscopic sleeve gastrectomy. Across all procedures, in-hospital complication rates were low.
Authors noted the benefit of using metabolic and bariatric surgery to reverse comorbidities like insulin resistance and hypertension.
“Though a proven safe and effective weight loss intervention, pediatric MBS is underutilized with disproportionately lower rates among minority groups,” they wrote. “Further investigation into the racial and social determinants that limit access to MBS is essential to combat this growing public health crisis.”
- AAP policy Pediatric Metabolic and Bariatric Surgery: Evidence, Barriers, and Best Practices
- AAP interim guidance Obesity Management and Treatment During COVID-19
- AAP clinical report The Role of the Pediatrician in Primary Prevention of Obesity
- AAP Institute for Healthy Childhood Weight
- Bright Futures health initiative
- Information from HealthyChildren.org on obesity