AAP Releases New Bariatric Surgery Recommendations

The American Academy of Pediatrics has released a new policy statement on bariatric surgery in pediatric patients.

“Metabolic and bariatric surgery has emerged as an important treatment for adults with severe obesity and, more recently, has been shown to be a safe and effective strategy for groups of youth with severe obesity. However, current data suggest that youth with severe obesity may not have adequate access to metabolic and bariatric surgery, especially among underserved populations,” they wrote.

Among the recommendations:

• Healthcare providers should recognize that severe obesity puts patients at greater risk for various health conditions. They should recognize patients who meet the criteria for surgery and provide timely referrals to pediatric-focused metabolic and bariatric surgery programs.
• Adolescents with class 2 obesity as well as clinically significant disease, including obstructive sleep apnea, type 2 diabetes, or hypertension, or those with class 3 obesity are eligible for surgery.
• Healthcare providers should monitor patients postoperatively for micronutrient deficiencies and for risk-taking behavior and mental health problems.

Contraindications for bariatric surgery in this population include a medically correctable cause of obesity; an ongoing substance abuse problem; a medical, psychiatric, psychosocial, or cognitive condition preventing adherence to postoperative regimens; and current or planned pregnancy within 12 to 18 months.

—Michael Potts

Reference:

Armstrong SC, Bolling CF, Michalsky MP, et al. Pediatric metabolic and bariatric surgery: evidence, barriers, and best practices [published online October 27, 2019]. Pediatrics. https://doi.org/10.1542/peds.2019-3223.