Two Children and a Group of Trees

Metabolic Surgery in Youth Becoming Less Rare

Metabolic and Bariatric Surgeries 2015 to 2021Plenty of people have strong feelings about metabolic and bariatric surgery (MBS) for young persons. The idea that it might even be an option for youth can inflame the passions of people who are happy to dictate what medical care should and should not be available to other people. This response drew a lot of attention when a new guideline appeared this year from the American Academy of Pediatrics. But young persons with severe obesity are facing the facts of their condition. As a result, metabolic surgery is youth is becoming less rare.

In fact, a new paper yesterday in JAMA Pediatrics tells us that use of metabolic surgery by youth increased after policy guidance in 2019 on the subject. In the same time frame (2020-2021), metabolic surgery for adults actually declined a bit because of the pandemic. We have Sarah Messiah and colleagues to thank for this analysis.

Lowering Barriers to Care

The authors see good news in these numbers. They write:

“The AAP has highlighted the need to educate pediatricians about the benefits of MBS for qualified patients. Historically, MBS has been underused in youths due to barriers, including low referral rates, limited access, and poor insurance coverage. In a recent study, our research group reported sustained weight, comorbidity reductions, and low long-term complication rates a decade after MBS in patients aged 15 to 21 years.

“A study limitation is that the MBSAQIP data may not be representative of all MBS practices in the US. Nevertheless, results of the present study suggest cautious optimism regarding the decreasing barriers to MBS for those US youth in need.”

More often than we would like, we run across hot-headed remarks from people who would pass judgment on the medical needs of young persons they have never met. These data suggest that such prejudicial attitudes will not carry the day.

Click here for the study by Messiah et al and here for further reporting on it. For perspective on the importance of medical autonomy, click here.

Two Children and a Group of Trees, painting by Harriet Backer / WikiArt

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May 31, 2023

One Response to “Metabolic Surgery in Youth Becoming Less Rare”

  1. May 31, 2023 at 8:29 am, Allen Browne said:

    With perhaps 5 million children with severe obesity in the United States, 1400 MBS cases per year may be progress, but it is painfully slow for the other 4,998,600 kids with the disease of obesity.

    Lots to do.