What Is the Evidence for Paediatric/Adolescent Bariatric Surgery?

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Term Occurence Count Dictionary
type 2 diabetes mellitus 1 endocrinologydiseases
beriberi 1 endocrinologydiseases
childhood obesity 4 endocrinologydiseases
diabetes mellitus 2 endocrinologydiseases
metabolic syndrome 4 endocrinologydiseases
obesity 38 endocrinologydiseases
osteoporosis 1 endocrinologydiseases

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beriberi 28835 nutritional deficiencies [[], []]. This can manifest clinically as peripheral neuropathy (inadequate B12), beriberi syndrome (B1 deficiency), iron deficiency anaemia and osteoporosis and osteopenia. Overall, 72% had
childhood obesity 1998 and predisposing patients to a significant risk of premature morbidity and mortality [[]]. As such, childhood obesity is fast becoming the most significant threat to the health of our younger generations.Lifestyle interventions
childhood obesity 4010 shown to have a strong positive correlation with adverse cardiovascular risk profile [[]].Prevalence of childhood obesity has risen by 47.1% between 1980 and 2013. Although the overall proportion of childhood obesity appears
childhood obesity 4105 [[]].Prevalence of childhood obesity has risen by 47.1% between 1980 and 2013. Although the overall proportion of childhood obesity appears to have plateaued out over the last decade, there is no convincing evidence of a sustainable
childhood obesity 19546 mellitus (T2DM) in young people has risen significantly over the last 25 years following the rise in childhood obesity . Whilst in 1992, it accounted for 3% of all new cases of diabetes in children [[]]; it currently accounts
diabetes mellitus 7962 informed assent for surgical management.Comorbid conditions • Serious comorbidities • Type 2 diabetes mellitus • Obstructive sleep apnoea • Pseudotumor cerebriLess serious comorbidities • Weight related
diabetes mellitus 19435 should decrease in severely obese adolescents undergoing bariatric surgery.The prevalence of type 2 diabetes mellitus (T2DM) in young people has risen significantly over the last 25 years following the rise in childhood
metabolic syndrome 1664 has become an increasing concern due to the rising prevalence of associated co-morbidities including metabolic syndrome and diabetes, obstructive sleep apnoea syndrome (OSAS) and psychosocial impairments, at ever-younger
metabolic syndrome 16433 at time of operation. In addition, a statistically significant ongoing decline in the prevalence of metabolic syndrome was noted with hypertension found in 19 vs 47% at operation, dyslipidaemia in 38 vs 86% and type 2 diabetes
metabolic syndrome 17313 affecting almost all organ systems. It has long been recognised that obese children are at a high risk of metabolic syndrome , a constellation of glucose resistance, hypertension and hypercholesterolemia. Regression modelling
metabolic syndrome 17765 of hypertension and 25% rise in insulin concentration. Because the cardiovascular complications of metabolic syndrome result from cumulative years of exposure and subsequent atherosclerosis, earlier onset of obesity equates
obesity 308 date (ppub): /2017AbstractPurpose of ReviewIn spite of the increasing prevalence of severe and complex obesity in children, surgery as a potential management option is still not widely accepted. The purpose of this
obesity 626 Increasing evidence supports early rather than later use of bariatric surgery in the treatment of extreme obesity .Recent FindingsPrior to 2007, the feasibility and safety of surgery have been reported by predominantly
obesity 1541 environments with specialist multi-disciplinary teams.IntroductionObesity is a global epidemic. Childhood obesity in particular has become an increasing concern due to the rising prevalence of associated co-morbidities
obesity 1867 at ever-younger ages. These co-morbidities have a cumulative health impact, making the duration of obesity increasingly important and predisposing patients to a significant risk of premature morbidity and mortality
obesity 2008 predisposing patients to a significant risk of premature morbidity and mortality [[]]. As such, childhood obesity is fast becoming the most significant threat to the health of our younger generations.Lifestyle interventions
obesity 2189 generations.Lifestyle interventions have been shown to have limited success in treatment of severe obesity in children. In adults, sustained BMI reduction and significant and definitive risk reductions for developing
obesity 2901 exist in order to delineate the future of this growing problem.Prevalence of Childhood ObesityDefining obesity in children presents slightly different challenges to that in adults. The body mass index (BMI) provides
obesity 3149 fat, whilst being easy to measure and subsequently calculate. As such, standard levels of BMI classify obesity in adults; if the BMI > 30 kg/m2, this is considered obese. Children have varying proportions of
obesity 3675 many standard deviations a child’s BMI is above the mean, are used to provide set definitions of obesity . The most widely used definition of ‘severe’ obesity is a BMI > 99th centile, broadly equivalent
obesity 3732 mean, are used to provide set definitions of obesity. The most widely used definition of ‘severe’ obesity is a BMI > 99th centile, broadly equivalent to a BMI Z-score of +2.5, an adult BMI equivalent 30 kg/m2
obesity 4020 a strong positive correlation with adverse cardiovascular risk profile [[]].Prevalence of childhood obesity has risen by 47.1% between 1980 and 2013. Although the overall proportion of childhood obesity appears
obesity 4115 childhood obesity has risen by 47.1% between 1980 and 2013. Although the overall proportion of childhood obesity appears to have plateaued out over the last decade, there is no convincing evidence of a sustainable
obesity 4531 Based on a definition of a BMI > 99th centile, 2.9% of girls and 3.9% of boys in the UK have severe obesity [[]]. This finding is paralleled in other developed countries with the prevalence of severe obesity
obesity 4631 obesity [[]]. This finding is paralleled in other developed countries with the prevalence of severe obesity affecting approximately 4% of US adolescents [[]]. This is an effect now seen in developing countries
obesity 4807 now seen in developing countries with a 60% increase in prevalence in recent years [[]]. Childhood obesity is, therefore, a truly global phenomenon of growing concern.Effect of Lifestyle Intervention as Treatment
obesity 5106 sustainable results. A 2009 Cochrane review of combined behavioural and lifestyle management of paediatric obesity in 5230 patients as compared to controls demonstrated a − 0.06 overall reduction of BMI-SDS in the
obesity 5513 addition, children with a lower BMI (30–35) achieved better results than those deemed to more extreme obesity (BMI 35+), indicating lifestyle intervention is more effective in those with lower BMI scores.Rationale
obesity 6580 suggested that although they were all similar, they lacked uniformity regarding the age and severity of obesity at which intervention should be offered [[]]. NICE (National Institute for Health and Clinical Excellence,
obesity 7348 surgery should fulfil all of the below criteria✓ Be very severely obese (BMI ≥ 40) with serious obesity related co-morbidities✓ Have attained or depending on the severity of co-morbidity, nearly attained
obesity 8437 steatohepatitis) • Gastroesophageal reflux • Severe psychosocial distressAvailable at https://www.ipeg.org/morbid obesity /. Copyright ©International Paediatric Endosurgery Group (IPEG), used with permissionThere is no specific
obesity 9310 practitioner with training in adolescent medicine.A registered dietician with experience in treating obesity and working with children and families.A mental health specialist; a psychiatrist or psychologist with
obesity 9532 training in paediatrics +/− adolescents and particular experience in treating eating disorders and obesity . In addition, the practitioner should have experience evaluating patients and families for bariatric
obesity 12041 set of prospective long-term (>5 years) outcomes have been published by both the adolescent morbid obesity surgery (AMOS) and Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) consortiums providing
obesity 13739 26% with sleeve gastrectomy, which was sustained at 3 years. Convincing improvements were made in obesity -related co-morbidities; remission of diabetes was seen in 95% of patients, with similar improvements
obesity 14328 published prospective results of subgroups of their cohort with regard to prevalence and resolution of obesity -associated co-morbidities that will be later discussed.The AMOS study is a Swedish multi-centre consortium
obesity 17106 levels than that seen in those with higher initial BMI.Resolution of Co-morbiditiesIncreased paediatric obesity has also seen rise in the prevalence of obesity-related co-morbidities at ever younger ages, affecting
obesity 17154 BMI.Resolution of Co-morbiditiesIncreased paediatric obesity has also seen rise in the prevalence of obesity -related co-morbidities at ever younger ages, affecting almost all organ systems. It has long been recognised
obesity 17874 syndrome result from cumulative years of exposure and subsequent atherosclerosis, earlier onset of obesity equates to an increased risk of premature death from cardiovascular disease. A retrospective review
obesity 19556 (T2DM) in young people has risen significantly over the last 25 years following the rise in childhood obesity . Whilst in 1992, it accounted for 3% of all new cases of diabetes in children [[]]; it currently accounts
obesity 20908 diabetes after bariatric surgery in adolescents compared to adults, possibly due to a shorter duration of obesity and reduced severity of disease at presentation. Panunzi et al. combined data from the Swedish Obesity
obesity 21406 operating on adolescents earlier.Non-alcoholic fatty liver disease (NAFLD) is strongly associated with obesity and is considered a spectrum of pathology ranging from NAFLD to non-alcoholic steatohepatitis (NASH),
obesity 21608 (NASH), with a 20% 10-year progression to cirrhosis and fibrosis. With the increasing prevalence of obesity , NASH is currently the primary cause of liver function abnormalities and chronic liver disease in children
obesity 23637 demonstrated a 40% reduction in apnoea score at 5 weeks compared to controls [[]].The consequences of obesity on psychosocial well-being are also not to be underestimated. Multiple studies have demonstrated significant
obesity 25141 also suggest the need to intervene earlier prior to the development of psychosocial consequences of obesity in formative adolescent years.The Teen-LABS consortium has also shown the effects of adolescent bariatric
obesity 25691 quality of life [[]]. In addition, a range of carcinomas has also been independently associated with obesity including breast, colorectal, endometrial, hepatic and pancreatic [[]]. As obesity has become a phenomenon
obesity 25774 associated with obesity including breast, colorectal, endometrial, hepatic and pancreatic [[]]. As obesity has become a phenomenon over the last 30 years, it is possible we are yet to reach the peak of this
obesity 30675 beginning to emerge from the teen-LABS group.ConclusionsEpidemiologic data has confirmed that paediatric obesity is increasing in prevalence and severity. Increasing studies have shown that obesity in the adolescent
obesity 30760 that paediatric obesity is increasing in prevalence and severity. Increasing studies have shown that obesity in the adolescent age group increases mortality due to a multitude of associated co-morbidities.Multiple
osteoporosis 28898 peripheral neuropathy (inadequate B12), beriberi syndrome (B1 deficiency), iron deficiency anaemia and osteoporosis and osteopenia. Overall, 72% had a variation of nutritional deficiency in the AMOS study with ‘several’
type 2 diabetes mellitus 19428 mortality should decrease in severely obese adolescents undergoing bariatric surgery.The prevalence of type 2 diabetes mellitus (T2DM) in young people has risen significantly over the last 25 years following the rise in childhood

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