Bariatric surgery in children and adolescents

Olga Gluzman, Julia Kovalov, Daniel S. Moran
Department of Health Systems Management, Ariel University



Background: According to a  2016 World Health Organization (WHO) report, 220 million children worldwide are considered overweight or obese. Obesity has negative consequences on health and well-being of children and youths, including a higher mortality rate than that found among healthy children. Obese children are at greater risk of developing co-morbidities such as type 2 diabetes, heart failure, and hypertension. Typically, a child with obesity is treated by a multidisciplinary team, with an emphasis on promoting a healthy life style, which includes exercise and a healthy diet. Unfortunately, in the long term, many of these children will become obese adults. Therefore, in the more difficult cases, bariatric surgery is the treatment of choice, suggested by many physicians. In Israel there are clear criteria set by the Ministry of Health for the performance of bariatric surgery on children and adolescents.


Objective: To examine and review the literature on the issues and the consequences relating to children and youth undergoing bariatric surgery.


Methods: A search of the databases PubMed and Google Scholar was conducted using the following keywords: bariatric surgery, obesity, childhood obesity, diet, exercise, children, and youth.  Inclusion criteria included Hebrew- and English-language articles published between January 2005 and May 2016 that matched the keywords.


Results: A total of 24 articles met the inclusion criteria and were included in this review. There is consensus in the literature on the importance of treating childhood obesity, as the high probability of obesity in adulthood may incur a high risk of developing comorbidities. The best treatment approach is conservative and preventative. However, when the desired results are not achieved, surgical treatment is considered. In the last decade, bariatric surgery has become a more popular modality for treating obesity in children and adolescents.


Conclusions: The focus of the majority of scientific publications on bariatric surgery is on the adult population, with only a few instances of research data pertaining to the population of children. Although bariatric surgery offers an effective solution to the problem of obesity among children and teens, there is still a knowledge gap on issues related to the surgical intervention and on its long-term effects


Keywords: Bariatric surgery, Obesity, Childhood obesity, Diet, Exercise, Children, Youth

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