Childhood Obesity in the United Kingdom 103An updated systematic review and meta-analysis, 2003-2012, by Chang et
al. [94] looked at the effectiveness and risks of bariatric surgery. The analysis
included a total of 164 studies (37 randomized clinical trials and 127
observational studies), with 161,756 patients -mean age of 44.56 years and
body mass index of 45.62. The results showed a reduction in BMI at 5 years
post-surgery of 12 to 17. The complication rate was 17% (95% CI, 11%-23%),
and the reoperation rate was 7% (95% CI, 3%-12%). Gastric bypass was noted
to be more effective in weight loss but it was associated with more
complications. Adjustable gastric banding had a lower mortality and
complication rate; yet, the reoperation rate was higher and weight loss was
much lower than for gastric bypass surgery. Results for sleeve gastrectomy
showed more effective in weight loss than adjustable gastric banding and
comparable rates with gastric bypass.
The Cochrane systematic review by Colquitt et al. (2014), -which was an
update of previous reviews in 2003 and 2009- reviewed randomised controlled
trials (last search November 2103) comparing surgical interventions with non-
surgical management of obesity or overweight or comparing different surgical
procedures. A total of 1798 participants from 22 studies were included, with
sample sizes ranging from 15 – 250. Their results were consistent with
previous published data, showing that surgical interventions result in greater
weight loss outcomes and more improvement in weight associated
comorbidities when compared with non-surgical interventions, irrespective of
the type of procedures employed. Outcomes were better for LRYGB and LSG
compared to LAGB. Most studies reported follow-up of upto 2 years, therefore
there is still a lack of long-term follow-up data, in addition adverse event rates
and reoperation rates were generally poorly reported across all the studies [98].
Of all the bariatric surgery procedures done in the UK according the
NBSR report, 1.6% of the publically funded procedures (and 2.4% of privately
funded surgery) represented gastric balloon insertion. This is a relatively new
form of bariatric surgery and the procedure involves inserting an. It is
discussed in further detail below.
Bariatric Surgery in Children and Adolescents
Considerations
Bariatric surgery in children has proved to be a largely controversial issue
in many settings, including in the UK [99-101]. Perception amongst the
healthcare professionals is much more supportive however. In a survey of