期刊
SURGERY FOR OBESITY AND RELATED DISEASES
卷 14, 期 7, 页码 882-901出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.soard.2018.03.019
关键词
Pediatric; Adolescent; Bariatric surgery; Metabolic and bariatric surgery; Weight loss surgery; Type 2 diabetes; Guidelines; Childhood obesity; Adolescent obesity; Guidelines for adolescent bariatric surgery; Morbid obesity
类别
资金
- NIDDK NIH HHS [P30 DK040561, R01 DK103946] Funding Source: Medline
- NIMHD NIH HHS [L60 MD008320] Funding Source: Medline
- NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES [R01DK103946, P30DK040561] Funding Source: NIH RePORTER
The American Society for Metabolic and Bariatric Surgery Pediatric Committee updated their evidence-based guidelines published in 2012, performing a comprehensive literature search (2009-2017) with 1387 articles and other supporting evidence through February 2018. The significant increase in data supporting the use of metabolic and bariatric surgery (MBS) in adolescents since 2012 strengthens these guidelines from prior reports. Obesity is recognized as a disease; treatment of severe obesity requires a life-long multidisciplinary approach with combinations of lifestyle changes, nutrition, medications, and MBS. We recommend using modern definitions of severe obesity in children with the Centers for Disease Control and Prevention age- and sex-matched growth charts defining class II obesity as 120% of the 95th percentile and class III obesity as 140% of the 95th percentile. Adolescents with class II obesity and a co-morbidity (listed in the guidelines), or with class III obesity should be considered for MBS. Adolescents with cognitive disabilities, a history of mental illness or eating disorders that are treated, immature bone growth, or low Tanner stage should not be denied treatment. MBS is safe and effective in adolescents; given the higher risk of adult obesity that develops in childhood, MBS should not be withheld from adolescents when severe co-morbidities, such as depressed health-related quality of life score, type 2 diabetes, obstructive sleep apnea, and nonalcoholic steatohepatitis exist. Early intervention can reduce the risk of persistent obesity as well as end organ damage from long standing co-morbidities. (C) 2018 Published by Elsevier Inc. on behalf of American Society for Metabolic and Bariatric Surgery.
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