Bariatric Surgery in Youth and Adolescents: The Experience of an Outpatient Obesity Clinic in a Central Hospital in Portugal

Date of submission: 22-11-2019 | Date of acceptance: 22-03-2020 | Published: 01-07-2020

Abstract

Obesity in children and adolescents is a huge Public Health burden. Lifestyle modification interventions in in some youth with severe obesity show only marginal effectiveness. As a result of the significant prevalence rate of severe comorbidities and substantial long-term health risks associated with pediatric obesity, bariatric surgery has emerged as an option for adolescents with severe obesity and/or serious weight-related comorbidities who have experienced insufficient responses with other treatments. Weight loss surgery should be conducted in the context of a multidisciplinary program. The purposes of this report were to analyze retrospectively the impact of bariatric surgery in body mass index (BMI) and improvements of comorbidities in severely obese adolescents followed at the Obesity Pediatric Outpatient Clinic of Centro Hospitalar Lisboa Norte (CHLN) between 2012-2016. Twelve adolescents underwent bariatric procedure during this period.  The most prevalent comorbidities were hypertension and insulin resistance. Mean BMI, after one year, decreased from 48,9kg/m² at baseline to 38,9kg/m². Improvements have been seen for many of the comorbidities. Regarding adverse events, two major surgical complications took place, two cases of depression and one weight regain with binge eating. The follow-up of these patients suggest that bariatric surgery appears to be effective in weight loss and reduction of comorbidities, however surgery and medical complications related to the surgical procedure are not negligible. Future studies should analyze the impact of the different surgical procedures and postoperative care on the minimization of adverse events as well as the long-term follow-up into adulthood.