Assessment and preparation of obese adolescents for bariatric surgery

Obesity is generally considered an adult disease, although there has been a constant increase in the prevalence of overweight and obese children in the last few decades. Childhood obesity is not limited to developed countries, with increasing numbers being reported from developing countries as well as from Saudi Arabia. Young populations with obesity suffer from similar comorbidities as obese adults, including type 2 diabetes mellitus, dyslipidemia, obstructive sleep apnea, polycystic ovarian syndrome, pseudotumor cerebri, and fatty liver disease. Recent advances in weight loss surgery have given hope to obese adolescents who are refractory to lifestyle changes and low-calorie diet plans. This review emphasizes a holistic approach for obese adolescents and describes in detail a multidisciplinary team and their role in adolescent bariatric surgery. There are unique medical, psychological, and nutritional requirements during the pre-operative, immediate post-operative, and long-term phases to achieve a desirable outcome. Identification of an appropriate candidate for bariatric surgery is critical and must balance the risks and benefits of weight loss surgery. Different surgical procedures are available and should be tailored to the needs of the patient and the expertise of the surgeon.