TY - JOUR
T1 - Inpatient weight loss as a precursor to bariatric surgery for adolescents with extreme obesity
T2 - Optimizing bariatric surgery
AU - Koeck, Emily
AU - Davenport, Katherine
AU - Barefoot, Leah C.
AU - Qureshi, Faisal G.
AU - Davidow, Daniel
AU - Nadler, Evan P.
PY - 2013/7
Y1 - 2013/7
N2 - Background. As the obesity epidemic takes its toll on patients stricken with the disease and our health care system, debate continues regarding the use of weight loss surgery and its long-term consequences, especially for adolescents. One subset of patients regarding whom there is increased controversy is adolescents with extreme obesity (BMI > 60 kg/m2) because the risk of complications in this weight category is higher than for others undergoing bariatric surgery. Several strategies have been suggested for this patient group, including staged operations, combined operations, intragastric balloon use, and endoluminal sleeve placement. However, the device options are often not available to adolescents, and there are no data regarding staged or combined procedures in this age group. Methods. All adolescents with BMI >60 kg/m2 referred to our program were evaluated for inpatient medical weight loss prior to laparoscopic sleeve gastrectomy. The program utilizes a multidisciplinary approach with a protein-sparing modified fast diet, exercise, and behavioral modification. Results. Three patients completed the program, and each achieved significant preoperative weight loss through the inpatient program and successfully underwent bariatric surgery. Conclusions. Presurgical weight loss via an inpatient program for adolescents with a BMI >60 kg/m2 results in total weight loss comparable to a primary surgical procedure alone, with the benefit of decreasing the perioperative risk.
AB - Background. As the obesity epidemic takes its toll on patients stricken with the disease and our health care system, debate continues regarding the use of weight loss surgery and its long-term consequences, especially for adolescents. One subset of patients regarding whom there is increased controversy is adolescents with extreme obesity (BMI > 60 kg/m2) because the risk of complications in this weight category is higher than for others undergoing bariatric surgery. Several strategies have been suggested for this patient group, including staged operations, combined operations, intragastric balloon use, and endoluminal sleeve placement. However, the device options are often not available to adolescents, and there are no data regarding staged or combined procedures in this age group. Methods. All adolescents with BMI >60 kg/m2 referred to our program were evaluated for inpatient medical weight loss prior to laparoscopic sleeve gastrectomy. The program utilizes a multidisciplinary approach with a protein-sparing modified fast diet, exercise, and behavioral modification. Results. Three patients completed the program, and each achieved significant preoperative weight loss through the inpatient program and successfully underwent bariatric surgery. Conclusions. Presurgical weight loss via an inpatient program for adolescents with a BMI >60 kg/m2 results in total weight loss comparable to a primary surgical procedure alone, with the benefit of decreasing the perioperative risk.
KW - bariatric surgeries
KW - morbid obesity
KW - weight reduction
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U2 - 10.1177/0009922813482516
DO - 10.1177/0009922813482516
M3 - Article
C2 - 23532489
AN - SCOPUS:84878858067
SN - 0009-9228
VL - 52
SP - 608
EP - 611
JO - Clinical Pediatrics
JF - Clinical Pediatrics
IS - 7
ER -