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Bariatric Surgery in Youth Warrants Caution

Studies suggest surgery may be effective in older children but long-term data are still lacking

WEDNESDAY, March 23 (HealthDay News) -- Bariatric surgery in older children may result in significant weight loss and improvement in quality of life, though long-term data on safety, efficacy, and cost-effectiveness are limited, according to a literature review published online March 3 in Clinical Obesity.

Andrea Aikenhead, of the International Association for the Study of Obesity in London, and colleagues conducted a systematic review of the effectiveness of surgical interventions for obesity in children and adolescents. The researchers examined 37 studies, spanning 36 years, that included 831 obese individuals aged 19 or younger with postoperative follow-up of at least one year, and at least one postoperative weight loss measure.

The researchers found that bariatric surgery resulted in significant weight loss, with improvements in comorbid conditions and quality of life, especially among older children. However, the evidence was mainly based on underpowered, retrospective studies. All types of bariatric surgeries were associated with complications, including ulcers, intestinal leakage, wound infection, and others. Studies examining the cost-effectiveness of bariatric surgery in youth were limited; only one such study was identified, which considered laparoscopic adjustable gastric banding cost-effectiveness for adolescents.

"Postoperative complications, compliance and follow-up may be more problematic in adolescents than adults, and availability of long-term data on safety, effectiveness, and cost-effectiveness remain largely unknown. Pending an improvement in the quality of available evidence, a cautious approach to child and adolescent bariatric surgery is warranted," the authors write.

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