Bariatric surgery for adolescents with severe obesity is being performed more frequently. What is a reasonable minimum age for this important but irreversible procedure? Guidelines have suggested that teens needed to have reached adult height and pubertal maturity. However, new guidelines from the American Society for Metabolic and Bariatric Surgery have removed age restrictions and the recent policy statement from the American Academy of Pediatrics on bariatric surgery notes that there is insufficient evidence to support age-based limitation. Ogle et al (10.1542/peds.2020-024182) evaluated the impact of bariatric surgery in by age in teens to understand the potential impact of lowering the age.
The authors analyzed data from the Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) consortium involving 242 adolescents who received their bariatric surgery at 5 clinical centers 1997 through 2011. These youths were followed up 5 years later, with 66 patients being between 13 and 15 years of age and 162 being between 16 and 19 years of age at the time of their surgery. The authors looked at outcomes that included the percent change in body mass index five years out from baseline’ the proportion with hypertension, dyslipidemia and type 2 diabetes mellitus; nutritional abnormalities; and quality of life. The good news is that weight loss and quality of life were not different between the younger and older adolescents. Differences in other outcomes were few and not substantive. The results of this study suggest that younger age should not be a contraindication for referral for patients who might meet all the other clinical indications for bariatric surgery. If we want to reduce the complications of obesity in older children and adolescents, this study and its five-year outcomes should provide reassurance that earlier referrals for bariatric surgery in younger patients can be effective. We welcome you to weigh in with your opinion on this study by sharing your thoughts in response to this blog, posting a comment on our website or on our social media platforms that include Facebook, Twitter, and Instagram.