Inclusion and Exclusion criteria

Patients are eligible for inclusion in TEEN-BEST if they meet the following inclusioncriteria and not meet any of the exclusion criteria as presented below. Eligibility of the patients is assessed in a multidisciplinary meeting winthin the lifestyle management programs.

Inclusion criteria

In order to be eligible to participate in this study, a subject must meet all of the following criteria;

  • Participation of at least 12 months in a lifestyle intervention programme
  • Consensus in the multidisciplinary child obesity team;); the participant is fully committed to be successful in this program and is expected to continue with this effort after the bariatric surgery;
  • Consensus in the multidisciplinary child obesity team on the diagnosis of non-responding to multidisciplinary lifestyle interventions for now and the near future;
  • Age 13-17;
  • Tanner stage ≥IV;
  • Severe obesity according to IFSO criteria for bariatric surgery; BMI ≥40 kg/m2 with minor comorbidities or BMI ≥35 kg/m2 with at least one major comorbidity, corrected for age and sex according to the IOTF criteria.

Exclusion criteria

A potential patient who meets any of the following criteria will be excluded from participation in this study:

  • Unable to consent as appropriate;
  • Illiteracy (disability to read and understand questionnaires);
  • Secondary obesity, obesity caused by a medical condition;
  • Known syndrome or genetic disorder (such as Prader-Willi syndrome);
  • Skeletal immaturity (Tanner stage 3 or less) – pre-menarche – bone age < 15 years in boys;
  • Ongoing addiction (alcohol, drugs, medication);
  • Previous bariatric, gastro-esophageal reflux or gastric surgery;
  • Psychiatric disorders;
  • IBD;
  • Non-support / non-consent of both parents / caretakers of adolescents aged 13-15 years.