Background

In the Netherlands, adolescents with morbid obesity (severe overweight) are treated by adjusting their eating and exercise behavior (lifestyle intervention program). In one out of four adolescents this treatment is not successful. For this group of adolescents with severe obesity no other standard treatment is available in the Netherlands.

The standard treatment for adults with severe overweight is weight loss surgery (bariatric surgery). There are different types of weight loss surgery. The Roux-en-Y Gastric Bypass (RYGB) and the Gastric Sleeve (SG) are the most commonly performed bariatric procedures. Studies in adults have shown promising results for both types of weight loss surgeries regarding weight loss, prevention of additional diseases (diseases associated with serious overweight, such as diabetes and high blood pressure) and the quality of life.

Over the past years, weight loss surgery (RYGB and SG) is increasingly performed on adolescents with severe obesity who do not show successful weight reduction and remission of comorbidities in the lifestyle intervention programs. After weight loss surgery, these adolescents achieve a weight loss comparable to adults. In addition, the diseases associated with the severe overweight seem to improve even more in adolescents compared to adults. Improved quality of life, improved social contacts and improved performance at school are also seen.

To date, the RYGB and SG are the dominating bariatric techniques and are routinely used in adult as well as in adolescent bariatric surgery internationally. There is a strong international trend within adolescent bariatric surgery toward the increasing use of SG over RYGB, yet data is lacking to support the potential use of SG. So to date, we don’t know which type of surgery is the best to perform on adolescents suffering from severe obesity.

In the Netherlands, weight loss surgery in adolescents can only be performed as part of a medical research. In addition, patients can only apply after participating for at least twelve months in a lifestyle intervention program.