Adolescents being considered for weight loss surgery should be referred to specialized adolescent weight loss surgery programs, centers with a multidisciplinary team of allied health professionals with expertise in meeting the needs of bariatric patients.These programs may exist in primarily adult or pediatric hospitals, but basic institutional and program standards should be met (see below).
The adolescent bariatric patient-care team should include an experienced bariatric surgeon with a subspecialty interest in adolescent patients, a pediatrician who's expertise include weight management, a psychologist with adolescent expertise, a registered dietician with a focus in bariatric nutrition, an advanced practice nurse dedicated to coordinating the care of the adolescent weight loss surgery patient, and an expert in exercise physiology and physical activity. Some adolescents may have other specific needs that may require additional the expertise in adolescent medicine.
The following specialties should be available if needed:
- endocrinology
- pulmonology
- gastroenterology
- cardiology
- orthopedics
- ethics.
A number of bariatric programs who specialize in adolescent weight loss (surgical and non-surgical) already exist in the United States with more being established throughout the U.S.
General institutional and program standards for adolescent bariatric specialty centers include the following:
Institutional
- All levels of administration support weight loss surgery initiatives.
- Nursing and outpatient medical staff should have access to standardized clinical management protocols and patient care guidelines at all times.
- Throughout the clinic and/or hospital there should be medical equipment, diagnostic instruments, and furniture suited for the management of morbidly obese patients and their family members.
- Consultative services required for the care of extremely obese patients must be available/provided by the institution.
Bariatric Program
- The program surgeon(s) should be dedicated to bariatric care and continuing education and must meet the training criteria recommended by the American Society for Metabolic & Bariatric Surgery.
- The bariatric program must maintain a medical director with expertise in pediatrics who participates in the decision-making process leading to surgery and in postoperative care.
- A bariatric patient care coordinator must be on staff who is responsible for closely monitoring and providing the continuing education needed for the post operative care of the adolescent weight loss surgery patient.
- Psychology and dietary staff who have expertise in evaluating and managing the bariatric patient must be available.
- Long term medical follow-up should be provided for all patients undergoing weight loss surgery procedures. A monitoring/tracking system should also be used to assess outcomes.
Information courtesy of Dr. Thomas Inge.
Dr. Thomas Inge, Surgical Director of the Surgical Weight Loss Program for Teens at Cincinnati Children’s Hospital Medical Center, a national leader in the pediatric weight loss surgery field. Dr. Inge also serves as the chairman of Teen-LABS, the largest scientific study to date designed to learn more about the risks and benefits of surgery for teenage obesity. Click here to learn more about this study.
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