Table 1.

Indications and contraindications for adolescent metabolic and bariatric surgery (MBS)

Indications for adolescent MBS include
BMI ≥35 kg/m2 or 120% of the 95th percentile with clinically significant co-morbid conditions such as obstructive sleep apnea (AHI >5), T2D, IIH, NASH, Blount’s disease, SCFE, GERD, or hypertension; or BMI ≥40 kg/m2 or 140% of the 95th percentile (whichever is lower). A multidisciplinary team must also consider whether the patient and family have the ability and motivation to adhere to recommended treatments pre- and postoperatively, including consistent use of micronutrient supplements.
Contraindications for adolescent MBS include
A medically correctable cause of obesity An ongoing substance abuse problem (within the preceding yr) A medical, psychiatric, psychosocial, or cognitive condition that prevents adherence to postoperative dietary and medication regimens. Current or planned pregnancy within 12 to 18 mo of the procedure

BMI = body mass index; AHI = apnea-hypopnia index; T2D = type 2 diabetes; IIH = idiopathic intracranial hypertension; NASH = nonalcoholic steatohepatitis; SCFE = slipped capital femoral epiphysis; GERD = gastroesophageal reflux disease.