Department of Pediatric Surgery, Center for Healthy Weight and Nutrition, Nationwide Children’s Hospital, Ohio State University College of Medicine, 700 Children’s Drive, Suite ED379, Columbus, OH 43205, USA.
"The cause of death was determined to be sudden cardiac arrhythmia in association with previously undiagnosed dilated cardiomyopathy. 2. Discussion Although no formal consensus regarding eligibility criteria for adolescent bariatric procedures exists, a mounting body of evidence supports the utilization of previous guidelines set forth for the adult bariatric population as a result of the NIH's 1991 Consensus Conference on bariatric surgery   "
[Show abstract][Hide abstract] ABSTRACT: Recent evidence highlighting the potential metabolic benefits of “early” surgical weight loss on obesity-related comorbidities has resulted in a steady increase in the number of adolescent bariatric procedures performed in the Unites States. Despite current literature describing cardiovascular disease (CVD) risk in adults undergoing bariatric surgery, there is a paucity of corresponding information related to the severely obese adolescent population. The clinical case described in this report serves as a reminder that severely obese adolescents may have subclinical CVD that has been previously unanticipated based on age alone. Although “youth” may limit the development of atherosclerotic heart disease, it does not protect against the development of other serious cardiac conditions (i.e. cardiomyopathy and microvascular disease). As with the case of other obesity-related metabolic derangements, including type 2 diabetes mellitus, obstructive sleep apnea and hypertension, the degree of CVD burden should not be underestimated in this young but unhealthy population. This case provides stimulus for important questions regarding obesity-related CVD in the pediatric population and highlights the need to establish appropriate clinical assessment algorithms and perioperative guidelines to more accurately address potential CVD risk for the severely obese adolescent population undergoing all elective surgical intervention including bariatric procedures.
Journal of Pediatric Surgery Case Reports 09/2013; 1(9):321-324. DOI:10.1016/j.epsc.2013.08.013
[Show abstract][Hide abstract] ABSTRACT: Childhood obesity represents a significant challenge for paediatric healthcare delivery. As obesity rates increase, obese children and adolescents are at significant risk for the development of a myriad of medical and surgical problems as well as mental health problems. Moreover, children with mental health problems are increasingly presenting to their psychiatrists with obesity. Treatment of paediatric obesity requires a multidisciplinary approach with incorporation of the family into the treatment plan although still typically only offering suboptimal results. Paediatric providers from all disciplines should focus efforts primarily on obesity prevention and encouragement of healthy lifestyles, while incorporating treatment for obesity when such efforts fail. The goals of this article are to provide an overview of the epidemiology, pathophysiology, genetics, clinical features and treatment strategies for paediatric obesity.
International Review of Psychiatry 06/2012; 24(3):231-40. DOI:10.3109/09540261.2012.678816 · 1.80 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Rates of obesity in adolescents continue to rise, and available lifestyle and pharmacological interventions have had limited success in reducing excess weight and risk for comorbid health issues. However, ongoing health risks, psychosocial issues, and increased risk of mortality place these adolescents in jeopardy and warrant ongoing investigation for available treatments. Bariatric surgery for adults has had positive medical and psychological outcomes. However, bariatric surgery is a relatively new option for adolescents. Initial findings suggest positive results for excess weight loss and psychosocial improvements, but not without possible risks. Selection of appropriate candidates is essential in the process, specifically considering developmental maturity, family support, and resultant disease burden without surgery. Surgery is not a panacea for the obesity epidemic. Outcome studies are limited and long-term results are unknown, but for extremely obese adolescents, bariatric surgery is promising and should be considered a viable option for appropriate adolescent candidates.
International Review of Psychiatry 06/2012; 24(3):254-61. DOI:10.3109/09540261.2012.678815 · 1.80 Impact Factor
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