ASMBS endorses new policy statement from American Academy of Pediatrics

The American Academy of Pediatrics (AAP) has released a new policy statement, "Pediatric Metabolic and Bariatric Surgery: Evidence, Barriers, and Best Practices," calling for greater access to metabolic and bariatric surgery for children and adolescents with severe obesity, describing the surgery as "one of the few strategies that has been shown to be effective in treating the most severe forms of the chronic disease."

The American Society for Metabolic and Bariatric Surgery (ASMBS), the largest organization for bariatric surgeons in the nation, has endorsed the new policy statement, which recommends pediatricians refer patients to high-quality multidisciplinary centers that have extensive pediatric surgical experience and where pediatric specialists can evaluate and care for patients before and after metabolic and bariatric surgery. The statement also says public and private health insurance should cover the procedure and follow-up care.

"A significant body of evidence has been developed that shows metabolic and bariatric surgery is a safe and effective treatment for severe obesity in children and adolescents and age alone should not be a barrier to treatment," said Eric DeMaria, MD, President, ASMBS. "The ASMBS and AAP share a goal in increasing access to evidence-based treatments that reduce the burden of severe obesity and related diseases including type 2 diabetes, heart disease and hypertension, which are occurring more often in younger patients."

In 2018, the ASMBS updated its own pediatric metabolic and bariatric surgery guidelines from 2012 due to the significant increase in data supporting its use. The guidelines state that metabolic and bariatric surgery should be considered standard of care for children with severe obesity and that "children who suffer from obesity are at a significant disadvantage if they are denied metabolic and bariatric surgery."

The AAP policy statement was published on Oct. 27 in the journal Pediatrics. According to the AAP, severe obesity among youth is an "epidemic within an epidemic" and "portends a shortened life expectancy for today's children compared with those of their parents' generation." According to the group, lifestyle modification has achieved moderate short-term success among young children and those with less severe forms of obesity, but no studies demonstrate significant and durable weight loss among youth with severe obesity. Nearly 4.5 million adolescents in the U.S. have severe obesity.

A recent study in The New England Journal of Medicine found adolescents with severe obesity may experience even greater benefits than adults. The Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) found five years after gastric bypass, teens were more likely to experience diabetes (86% vs. 53%) and hypertension (68% vs. 41%) remission.