Advances in Medicine and Biology. Volume 107

Childhood Obesity in the United Kingdom 107

preventing complications of obesity, and specialist assessment for

eating disorder(s)

 information on the different procedures, including potential weight

loss and associated risks

 regular postoperative assessment, including specialist dietetic and

surgical follow up

 management of comorbidities

 psychological support before and after surgery

 information on or access to plastic surgery (such as apronectomy)

when appropriate

 access to suitable equipment, including scales, theatre tables, Zimmer

frames, commodes, hoists, bed frames, pressure-relieving mattresses

and seating suitable for children and young people undergoing

bariatric surgery, and staff trained to use them.

*Coordinate surgical care and follow‑up around the child or young person

and their family's needs. Comply with the approaches outlined in the

Department of Heath's A call to action on obesity in England.

*Ensure all young people have had a comprehensive psychological,

educational, family and social assessment before undergoing bariatric surgery.

*Perform a full medical evaluation, including genetic screening or

assessment before surgery to exclude rare, treatable causes of obesity.

Outcomes
Overall there is still relatively limited long term data on outcomes in
paediatric bariatric surgery. LRGBP surgery was the earliest surgical
intervention used in paediatrics. One of the earliest reports from 1975
describes a series of 25 adolescents (< 20 years) who underwent gastric bypass
surgery. There was an average weight loss of 15% of body weight at 6 months,
and 25% at 36 months [112]. More recent reports have described substantially
larger weight loss outcomes. In a systematic overview published in 2015
Canoy and Yany et al. [113] looked at the effectiveness and risks of bariatric
surgery in children. The main purpose of the review was to seek evidence from
randomised controlled trials (RCTs) to assess physical, psychosocial, and
quality-of life outcomes of bariatric surgery in childhood obesity compared to
appropriate control (i.e., no intervention, usual care, or waiting list control), or
of different types of bariatric surgery compared with each other. They
searched Medline, Embase, The Cochrane Library, and other important
databases up to August 2014 and after filtering for inclusion and exclusion