Bariatric Surgery for Older Children and Teens with Cognitive Impairment or Developmental
LewisFirst, MD, MS, Editor in Chief, Pediatrics
Bariatric surgery is more than just about the surgery. It requires pre-operative planning
and counseling to determine whether someone is motivated to begin to lose the weight
before the procedure as a way of indirectly indicating if they can keep weight from
reaccumulating after the operation. It also requires attention to proper diet, exercise,
and other prevention strategies to keep the weight from coming back. Thus one might
question whether an older child or teen who has a cognitive impairment or developmental
disability (CI/DD) is a good candidate for bariatric surgery such as a sleeve gastrectomy.
Hornack et al. (10.1542/peds.2018-2908) studied how effective bariatric surgery is for obese youth compared to youth without
CI/DD and found no post-op outcome. In fact, children with CI/DD who underwent a gastric
sleeve bariatric procedure lost more weight over time and were able to keep the weight
from coming back.
So what’s the take-away from this study? We asked pediatric and bariatric surgeon
Dr. Marc Michalsky (10.1542/peds.2018-4112) from Nationwide Children’s Hospital in Columbus, Ohio to share his thoughts in an
accompanying commentary. While Dr. Michalsky notes the small sample size and the
short follow-up period captured, he also notes that the support services that are
provided to these youth by their caregivers and other provider services may make compliance
with post-op care and diet easier. If you have ever referred a patient with CI/DD
for bariatric surgery only to find they were denied because of their disability, please
show that bariatric team and that patient and family this study and commentary so
they can undergo the surgery which appears to be a great way to lose the weight and
keep it off. Weigh into this study to learn more.