What are the weight-loss surgery guidelines for adolescents?

Joanna Yeh, MD
Pediatric Gastroenterology
Weight-loss (bariatric) surgery guidelines for adolescents include having a body mass index (BMI) of greater than 35 with major comorbidities. An adolescent with a BMI greater than 40 with some other comorbidities may also qualify. Fatty liver is a major comorbid condition. If the BMI is greater than 35 with severe fatty liver, that person may be considered for one of the bariatric surgery procedures.

Bariatric surgery is being offered to adolescents who are working with their pediatrician and gastroenterologist very closely but are still unable to lose weight. They have to undergo a rigorous 6- to 12-month medically supervised weight loss attempt before considering something as definitive as surgery.
We follow the same guidelines for adolescent and adult patients. These are the guidelines:
  • BMI (body mass index) between 35 and 40, and at least 75 pounds overweight with also an obesity-related disease, such as high blood pressure, type 2 diabetes or sleep apnea
  •  BMI greater than 40, or is at least 100 pounds overweight, with or without medical problems
At age 16 to 17, most adolescents are mature skeletally and have finished growing. And, they behave like adults with regards to obesity and the medical problems that come with it. However, teens have different psychological and social aspects to consider. To deal with this, we have psychologists and psychiatrists within our program to help us evaluate the patient, the family and the dynamics at home to make sure that surgery is the right choice for this youngster. 

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