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Adolescent bariatric surgery

Petter Bjornstad, David Z Cherney
PURPOSE OF REVIEW: Compared to adult-onset type 2 diabetes (T2D), youth with T2D have a more aggressive phenotype with greater insulin resistance (IR), more rapid β cell decline, and higher prevalence of diabetic kidney disease (DKD). RECENT FINDINGS: Hyperfiltration is common in youth with T2D and predicts progressive DKD. Hyperfiltration is a consequence of early changes in intrarenal hemodynamic function, including increased renal plasma flow (RPF) and glomerular pressure...
March 19, 2018: Current Diabetes Reports
Amanda I Lynch, Elizabeth McGowan, Kerstyn C Zalesin
BACKGROUND: Obesity can develop during any life stage. Understanding the contexts within which obesity develops can inform our understanding of the disease and help tailor interventions specific to life stages. OBJECTIVE: Using life-course theory as a guiding framework, this study aimed to explain the development of obesity in bariatric surgery patients by creating personalized weight trajectories. DESIGN: Qualitative methods using semistructured interviews were used to uncover participants' experiences with and explanations for the development of obesity...
March 15, 2018: Journal of the Academy of Nutrition and Dietetics
Thomas H Inge, Lori M Laffel, Todd M Jenkins, Marsha D Marcus, Natasha I Leibel, Mary L Brandt, Morey Haymond, Elaine M Urbina, Lawrence M Dolan, Philip S Zeitler
Importance: Because of the substantial increase in the occurrence of type 2 diabetes in the pediatric population and the medical complications of this condition, therapies are urgently needed that will achieve better glycemic control than standard medical management. Objective: To compare glycemic control in cohorts of severely obese adolescents with type 2 diabetes undergoing medical and surgical interventions. Design, Setting, and Participants: A secondary analysis of data collected by the Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) and Treatment Options of Type 2 Diabetes in Adolescents and Youth (TODAY) consortia was performed...
March 12, 2018: JAMA Pediatrics
Kirit Arumalla, Vitish Singla, Sandeep Aggarwal, Harshit Garg, Ritesh Goel, Varidh Katiyar
Introduction: There is a worldwide increase in the prevalence of obesity among the adolescent population in India from 16.3% in 2001 to 19.3% in 2010. Recent evidence suggests that bariatric surgery leads to resolution of comorbidities and associated long-term complications in adolescent patients with morbid obesity. Aim: The aim of this study is to determine the impact of bariatric surgery on the weight loss and comorbidities of morbidly obese adolescents. Materials and Methods: A retrospective review of the data of 10 adolescent patients, who underwent Laparoscopic Sleeve Gastrectomy at our institute (tertiary care hospital), from July 2009 to July 2016 was carried out...
February 27, 2018: Journal of Minimal Access Surgery
Marc P Michalsky
No abstract text is available yet for this article.
February 1, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Aashima Dabas, Anju Seth
Childhood obesity has been recognized as a global pandemic. Preventive strategies have proven to be the most effective public health intervention in curbing this pandemic. A multi-component approach involving dietary modification and advocacy for a healthy lifestyle comprising of regular physical activity, minimizing screen time and behavioral interventions have been found beneficial in preventing obesity. A life-cycle approach has been recommended where preventive interventions go as far back as affecting maternal, fetal and early childhood nutrition and lifestyle...
February 19, 2018: Indian Journal of Pediatrics
Nesreen Khidir, Moamena Ahmed El-Matbouly, Davit Sargsyan, Mohammed Al-Kuwari, Moataz Bashah, Michel Gagner
BACKGROUND: Bariatric surgery in adolescents is still under debate. Literature about the long-term impact of laparoscopic sleeve gastrectomy (LSG) on adolescents' obesity and associated morbidities is scarce. It is unknown if LSG shows better long-term results in the adolescent or adult group. AIM: To compare the long-term effectiveness of LSG on obesity and associated comorbidities between adolescents and adults. METHODS: This retrospective study analyzed all patients with morbid obesity who underwent LSG in (2011-2012) and were followed for up to 5 years...
February 11, 2018: Obesity Surgery
Sarah B Cairo, Indrajit Majumdar, Aurora Pryor, Alan Posner, Carroll M Harmon, David H Rothstein
Obesity in pediatric patients is rising with nearly one third of children in the USA classified as overweight and up to 16-18% of the adolescent population obese with at least one comorbid condition. Consequently, bariatric procedures in this population have increased without consistent recommendations for follow-up and transition to adult providers. This review describes the known and potential long-term consequences of bariatric surgery in pediatric patients, reviews the current literature on transitions of care for adolescent patients with chronic illnesses...
February 9, 2018: Obesity Surgery
Stephanie Davis, Edward Nehus, Thomas Inge, Wujuan Zhang, Kenneth Setchell, Mark Mitsnefes
BACKGROUND: Untreated severe obesity of adolescents is associated with abnormal kidney function and development of chronic kidney disease. Lipotoxicity due to lipid accumulation in glomeruli might be an important mechanism in the progression of kidney disease in obesity. OBJECTIVE: To assess subclinical glomerular injury by measuring urinary sphingolipids in adolescents with severe obesity before and after weight loss surgery. We hypothesized that the levels of urinary sphingolipids would be elevated at baseline and improve after weight reduction...
December 29, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
J Doyle, S Colville, P Brown, D Christie
The National Institute of Clinical Excellence states that bariatric surgery may be considered for adolescents with severe obesity in 'exceptional circumstances'. However, it is not clear what is deemed to be exceptional, and there is a lack of long-term outcomes data or research, which would inform patient selection. This is an in-depth qualitative study involving five adolescents who had previously undergone bariatric surgery (between 1 and 3 years postoperatively) and four who were being assessed for the treatment...
January 21, 2018: Clinical Obesity
Donald E Greydanus, Marisha Agana, Manmohan K Kamboj, Saad Shebrain, Neelkamal Soares, Ransome Eke, Dilip R Patel
This discussion reflects on concepts of obesity in children and adolescents in the early 21st century. It includes reflections on its history, definition, epidemiology, diagnostic perspectives, psychosocial considerations, musculoskeletal complications, endocrine complications and principles of management. In addition to emphasis on diet and exercise, research and clinical applications in the second decade of the 21st century emphasize the increasing use of pharmacotherapy and bariatric surgery for adolescent and adult populations with critical problems of overweight and obesity...
January 9, 2018: Disease-a-month: DM
Marc P Michalsky, Thomas H Inge, Todd M Jenkins, Changchun Xie, Anita Courcoulas, Michael Helmrath, Mary L Brandt, Carroll M Harmon, Mike Chen, John B Dixon, Elaine M Urbina
BACKGROUND AND OBJECTIVES: Severely obese adolescents harbor numerous cardiovascular disease risk factors (CVD-RFs), which improve after metabolic and bariatric surgery (MBS). However, predictors of change in CVD-RFs among adolescents have not yet been reported. METHODS: The Teen-Longitudinal Assessment of Bariatric Surgery study (NCT00474318) prospectively collected anthropometric and health status data on 242 adolescents undergoing MBS at 5 centers. Predictors of change in CVD-RFs (blood pressure, lipids, glucose homeostasis, and inflammation) 3 years after Roux-en-Y gastric bypass and vertical sleeve gastrectomy were examined...
February 2018: Pediatrics
Felipe E Pedroso, Federico Angriman, Atsushi Endo, Hormuzdiyar Dasenbrock, Alessandra Storino, Ricardo Castillo, Ammara A Watkins, Manuel Castillo-Angeles, Julie E Goodman, Jeffrey L Zitsman
Of adolescents in the United States, 20% have obesity and current treatment options prioritize intensive lifestyle interventions that are largely ineffective. Bariatric surgery is increasingly being offered to obese adolescent patients; however, large-scale effectiveness data is lacking. We used MEDLINE, Embase, and Cochrane databases, and a manual search of references to conduct a systematic review and meta-analysis on overall weight loss after gastric band, gastric sleeve, and gastric bypass in obese adolescent patients (age ≤19) and young adults (age ≤21) in separate analyses...
October 10, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Andrea B Goldschmidt, Jane Khoury, Todd M Jenkins, Dale S Bond, J Graham Thomas, Linsey M Utzinger, Meg H Zeller, Thomas H Inge, James E Mitchell
BACKGROUND: Loss-of-control (LOC) eating is common in adults undergoing bariatric surgery and is associated with poorer weight outcomes. Its long-term course in adolescent bariatric surgery patients and associations with weight outcomes are unclear. METHODS: Adolescents ( n = 234; age range = 13-19 years) undergoing bariatric surgery across 5 US sites were assessed for postsurgery follow-up at 6 months and 1, 2, 3, and 4 years. Descriptive statistics and generalized linear mixed models were used to describe the prevalence of LOC eating episodes involving objectively large amounts of food and continuous eating, respectively...
January 2018: Pediatrics
M Panca, R M Viner, B White, T Pandya, H Melo, M Adamo, R Batterham, D Christie, S Kinra, S Morris
Evidence shows that surgery for severe obesity in adults improves health and psychological functioning, and is cost-effective. Data on bariatric surgery for adolescents with severe obesity are extremely limited, with no evidence on cost-effectiveness. We evaluated the lifetime cost-effectiveness of bariatric surgery compared with no surgery in adolescents with severe obesity from the UK's National Health Service perspective. Eighteen adolescents with body mass index ≥40 kg m-2 who underwent bariatric surgery (laparoscopic Roux en Y Gastric Bypass [RYGB] [N = 9], and laparoscopic Sleeve Gastrectomy [SG] [N = 9]) at University College London Hospitals between January 2008 and December 2013 were included...
April 2018: Clinical Obesity
Sengwee Toh, Laura J Rasmussen-Torvik, Emily E Harmata, Roy Pardee, Rosalinde Saizan, Elisha Malanga, Jessica L Sturtevant, Casie E Horgan, Jane Anau, Cheri D Janning, Robert D Wellman, R Yates Coley, Andrea J Cook, Anita P Courcoulas, Karen J Coleman, Neely A Williams, Kathleen M McTigue, David Arterburn, James McClay
BACKGROUND: Although bariatric procedures are commonly performed in clinical practice, long-term data on the comparative effectiveness and safety of different procedures on sustained weight loss, comorbidities, and adverse effects are limited, especially in important patient subgroups (eg, individuals with diabetes, older patients, adolescents, and minority patients). OBJECTIVE: The objective of this study was to create a population-based cohort of patients who underwent 3 commonly performed bariatric procedures-adjustable gastric band (AGB), Roux-en-Y gastric bypass (RYGB), and sleeve gastrectomy (SG)-to examine the long-term comparative effectiveness and safety of these procedures in both adults and adolescents...
December 5, 2017: JMIR Research Protocols
Andrew J Beamish
No abstract text is available yet for this article.
November 10, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Thomas Reinehr
Obesity in adolescence will probably have major implications not only for the affected adolescents but also for society. Those who have obesity during adolescence usually have obesity into adulthood, which causes many medical and psychological issues that can result in premature death. Furthermore, obesity in adolescents is associated with a range of social problems, including difficulties securing an apprenticeship or a job or finding a partner. Adolescents with obesity are also at increased risk of having children with obesity later in life...
March 2018: Nature Reviews. Endocrinology
Charumathi Baskaran, Nurgun Kandemir
PURPOSE OF REVIEW: Although childhood obesity has leveled off in the last decade, 'severe obesity' continues to be on the rise. Various genetic, environmental and hormonal factors contribute to obesity. This article reviews the most current understanding of obesity's multifactorial origin and recent recommendations for its management in childhood and adolescence. RECENT FINDINGS: Epigenetics plays a key role in transmitting obesity risk to offspring. Single-nucleotide polymorphisms at genetic loci for adipokines and their receptors are associated with obesity...
February 2018: Current Opinion in Endocrinology, Diabetes, and Obesity
George G A Pujalte, Isabella Ahanogbe, McKennan J Thurston, Richard O White, Alva Roche-Green
There is an epidemic of pediatric obesity in the United States. In most cases, there is an excess in the amount of calories consumed, compared with the amount of calories expended. Numerous body systems are affected by pediatric obesity, with complications varying between boys and girls. Behavioral, genetic, and environmental factors affect the ability of children to avoid becoming obese. Primary care physicians should screen for obesity in children as much as possible. Associated risk factors for obesity should be uncovered...
2017: Global Pediatric Health
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