Surgical treatment :

Optimal timing

Neuroendocrine, skeletal and psychosocial maturation are accelerated during adolescence. The rapid somatic growth observed in early adolescence requires adequate nutrition. Therefore, bariatric procedures performed before the growth spurt could potentially compromise linear growth.

Physical examination should include evaluations of sexual maturation. Overweight children experience an early onset of puberty and are likely to achieve skeletal maturity earlier in adolescence compared with age matched non-over weight children.

If an individual has attained > 95% of adult stature then there is little concern that a bariatric procedure may significantly impair completion of linear growth.

Informed Consent

Should be obtained from the adolescent patient. Although bariatric procedures can result in substantial weight loss, the long term metabolic, nutritional and psychosocial effects among adolescents are unknown.

Laboratory and radiologic examinations

Choice of procedure: