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Metabolic and Bariatric Surgery in Children: Current Practices and Outcomes

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Abstract

Purpose of Review

This review will examine the most current evidence for Metabolic and Bariatric Surgery (MBS) in the pediatric population, specifically in terms of weight loss outcomes and improvement in comorbid conditions and complications. Additionally, we compare surgical and non-surgical interventions, review current guidelines, and propose a stepwise evidence-based approach to the management of obesity in children.

Recent Findings

MBS is a safe option for appropriately selected pediatric patients which leads to significant and sustained weight loss. This weight loss is associated with improvement of related comorbid conditions. Laparoscopic sleeve gastrectomy (LSG) has emerged as the procedure of choice with a better safety profile. Despite the evidence, very few adolescents undergo MBS. New pharmacologic agents specifically the GLP-1/GIP agents have shown early promise especially in patients under body mass index 40, but the long-term effects are unknown.

Summary

MBS is an effective tool in the management of pediatric obesity, and its use has been recommended by professional societies. Early referral to a multidisciplinary obesity team can help identify appropriate patients.

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Authors and Affiliations

  1. Aga Khan University, Karachi, Pakistan

    Shayan A. Shah

  2. Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, UPMC Mercy Hospital, Pittsburgh, PA, USA

    Noor A. Khan

  3. Division of Pediatric Surgery, Department of Surgery, University of Texas Southwestern Medical Center and, Children’s Medical Center Dallas, 1935 Medical District Drive, D2000, Dallas, TX, 75235, USA

    Faisal G. Qureshi

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  1. Shayan A. Shah
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  2. Noor A. Khan
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All authors made substantial contributions to the conception and design of the work. S.S and F.Q drafted the work. S.S, N.K, and F.Q revised it critically for important intellectual content; All authors approved the version to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Faisal G. Qureshi.

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Noor A. Khan received a speaker honorarium from Oakstone Publishing and Alameda Health System, Oakland, CA 94602. The other authors declare no competing interests.

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Shah, S.A., Khan, N.A. & Qureshi, F.G. Metabolic and Bariatric Surgery in Children: Current Practices and Outcomes. Curr Obes Rep 13, 77–86 (2024). https://doi.org/10.1007/s13679-023-00540-1

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