Metabolic and Bariatric Surgery on the Rise for Pediatric Patients

A study published in the Journal of the American Medical Association Tuesday found that pediatric surgery for weight loss is on the rise in the United States. Using data from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP), researchers showed that metabolic and bariatric surgery (MBS) increased by 18.85% for people aged 10–19 during the COVID-19 pandemic.

Results found that, between 2020 and 2021, MBS surgeries for Black youth included in the study population increased by 42%, surgeries for Hispanic youth increased by 53%, and surgeries for White youth increased by 13%. On the other hand, surgeries for adults decreased during the first year of the pandemic.

The study conducted by Sarah E. Messiah, PhD, and researchers from several academic medical centers analyzed 1.3 million records in the MBSAQIP, suggesting that MBS surgeries for US youth are likely to continue to rise in prevalence as rates of pediatric obesity grow.

“Historically, MBS has been underused in youths due to barriers, including low referral rates, limited access, and poor insurance coverage,” wrote the researchers. “Nevertheless, results of the present study suggest cautious optimism regarding the decreasing barriers to MBS for those US youth in need.”

The prevalence of obesity in children and adolescents sits at 20% in the US and is highest among Hispanic and Black children. Obesity is also lower among those in the top income groups and highest among children living in middle-income families.

The American Academy of Pediatrics (AAP) currently includes surgical interventions in its approach to treating pediatric obesity. The comprehensive obesity treatment guidelines created by AAP suggest that clinicians should utilize longitudinal treatment, monitor comorbidities, identify social determinants of health, and employ pharmacotherapy to effectively treat obesity in children.

Pharmaceutical treatments for pediatric obesity may soon involve oral butyrate supplementation after a recent JAMA study showed that the intervention significantly reduced BMI in obese children. Butyrate is a short-chain fatty acid produced by anaerobic bacteria, often the product of fermentation in the gut’s microbiome. Butyrate supplementation tends to be effective when a child does not already consume enough vegetables in their regular diet.

The FDA also recently approved the weight loss drug semaglutide for children over 12. Using semaglutide, often called Ozempic, has been shown to aid in weight loss in obese children, but the product has side effects that may restrict its long-term use.

Still, the most effective tool to fight childhood obesity is prevention. Experts recommend that education systems implement school-based programs that employ evidence-based strategies to engage young people and build positive lifelong habits.