Metabolic and bariatric surgery for pediatric obesity

Metabolic and bariatric surgery (MBS), which is endorsed by the American Academy of Pediatrics (AAP), is a safe and effective treatment for pediatric severe obesity and should be considered as an option, particularly in patients with weight-related health complications. MBS can result in significant and sustained long-term weight loss and can treat comorbid conditions such as type 2 diabetes, hypertension, obstructive sleep apnea (OSA), and non-alcoholic fatty liver disease (NAFLD). Patients undergoing MBS should be cared for by a multidisciplinary team. This team will provide comprehensive pre-operative groundwork that includes optimization of health with medical weight management, education on MBS, and preparation for lifestyle changes following surgery. The team will continue to follow patients for long-term post-operative care with monitoring for surgical complications, nutritional assessments, and ongoing weight management interventions, as needed. While the term "metabolic and bariatric surgery" encompasses a variety of procedure types, the laparoscopic sleeve gastrectomy (LSG) is currently the most commonly performed procedure in adult and pediatric patients.