What is Adolescent Bariatric Surgery?

Adolescent bariatric surgery refers to weight-loss surgery performed on young people between the ages of 12 and 19 who suffer from severe obesity and obesity-related health conditions that are not responsive to traditional medical or lifestyle interventions.

It is a safe and effective tool for improving both physical health and quality of life in adolescents with severe obesity.

Why is Bariatric Surgery Considered for Adolescents?

Childhood and adolescent obesity has reached epidemic levels globally, and for many adolescents with Class II or III obesity, non-surgical options such as diet, exercise, and medications often fail to produce lasting results.

Severe obesity in youth can lead to:

• Type 2 diabetes (often within a few years)

• Obstructive sleep apnea

• High blood pressure

• Fatty liver disease (NAFLD/NASH)

• Depression and social isolation

• Early cardiovascular disease and premature death

Bariatric surgery is not cosmetic — it is a medically necessary, life-saving intervention when appropriate.

Eligibility Criteria for Adolescent Bariatric Surgery

Eligibility follows criteria outlined by AAP and ASMBS, adjusted for the unique developmental needs of adolescents.

 Additional Requirements:

• Completed puberty (Tanner Stage IV or V is preferred)

• Demonstrated failure of ≥6 months of structured weight management efforts

• Emotional and psychological readiness

• Family support and commitment to lifelong follow-up

• No untreated psychiatric or eating disorders

Types of Bariatric Surgery in Adolescents

1. Sleeve Gastrectomy (VSG)

• Most common procedure in adolescents

• ~75–80% of the stomach is removed

• Restrictive + hormonal changes (less ghrelin/hunger)

• Effective, lower complication rate

• Fewer long-term nutritional issues than bypass

2. Roux-en-Y Gastric Bypass (RYGB)

• More complex, but effective

• Restrictive + malabsorptive

• Greater improvement in type 2 diabetes

• Higher risk of nutritional deficiencies and complications

• Used in cases where sleeve fails or for specific conditions (e.g., severe GERD)

3. Adjustable Gastric Banding

• Rarely used now due to poor outcomes and high revision rates

4. Mini Gastric Bypass (OAGB)

• Still being evaluated in adolescents

• May be used in specific high-risk cases

Conclusion

Adolescent bariatric surgery is a safe and effective option for treating severe obesity and improving long-term health outcomes in youth. It is not a quick fix, but a powerful tool when combined with:

• A dedicated support system

• Lifelong follow-up

• Healthy behavioral change

It offers adolescents the chance for a healthier, more fulfilling life—physically, emotionally, and socially.