Bariatric surgery in children

During my Masters in Epidemiology we had to complete two essays, and a thesis. This paper was from my second essay. As I am not an expert in obesity surgery, two old colleagues from my time in London came on as co-authors (Billy and Russell from UCLH).


The number of obese young people continues to rise, with a corresponding increase in extreme obesity and paediatric-adolescent bariatric surgery.

We aimed to;

  • systematically review the literature on bariatric surgery in children and adolescents
  • meta-analyse change in body mass index (BMI) 1-year post-surgery
  • report complications, co-morbidity resolution and health-related quality of life (HRQoL)

A systematic literature search (1955-2013) was performed to examine adjustable gastric band, sleeve gastrectomy, Roux-en-Y gastric bypass or biliopancreatic diversions operations among obese children and adolescents. Change in BMI a year after surgery was meta-analysed using a random effects model.

Meta-analysis of BMI change after bariatric surgery for adolescent obesity, by surgery type and overall. AGB, adjustable gastric banding; BMI, body mass index; BPD, biliopancreatic diversion; CI, confidence interval; RYGB, Roux-en-Y gastric bypass; SG, sleeve gastrectomy.

In total, 637 patients from 23 studies were included in the meta-analysis. There were significant decreases in BMI at 1 year (average weighted mean BMI difference: -13.5 kg m(-2) ; 95% confidence interval [CI] -14.1 to -11.9). Complications were inconsistently reported. There was some evidence of co-morbidity resolution and improvements in HRQol post-surgery. Bariatric surgery leads to significant short-term weight loss in obese children and adolescents. However, the risks of complications are not well defined in the literature. Long-term, prospectively designed studies, with clear reporting of complications and co-morbidity resolution, alongside measures of HRQol, are needed to firmly establish the harms and benefits of bariatric surgery in children and adolescents.


Black, J. A., White, B., Viner, R. M., & Simmons, R. K. (2013). Bariatric surgery for obese children and adolescents: a systematic review and meta-analysis. Obesity reviews, 14(8), 634–44. doi:10.1111/obr.12037

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