Nogueira Isadora, Hrovat Kathleen
Massachusetts General Hospital, Boston, Massachusetts
Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Nutr Clin Pract. 2014 Dec;29(6):740-6. doi: 10.1177/0884533614552851. Epub 2014 Oct 20.
The prevalence of obesity in adolescents has dramatically increased over the past 3 decades in the United States. Weight loss surgery is becoming a viable treatment option for obese adolescents. The number of surgeries being performed yearly is rising, and this trend is likely to continue. Adolescent patients present a unique challenge to clinicians. There are currently best-practice recommendations and evidence-based nutrition guidelines for the treatment of the adolescent bariatric patient. A review of the current literature was performed to discuss bariatric surgery and nutrition for the adolescent patient. Studies show that most adolescents with obesity will become obese adults, thus increasing their risk of developing serious and debilitating health conditions. It is recommended that the candidates for surgery be referred to a practice that has a multidisciplinary team experienced in meeting the distinct physical and psychological needs of adolescents. Specific nutrition concerns for the adolescent bariatric patient include preoperative educational pathway, postoperative dietary progression, female reproduction, compliance with vitamin/supplementation recommendations, laboratory tests, and long-term monitoring. The medical literature has reported positive outcomes of bariatric surgery in adolescents with severe obesity. Before surgery is offered as an option, unique factors to adolescents must be addressed. The multidisciplinary clinical team must consider the adolescents' cognitive, social, and emotional development when considering their candidacy for surgery. As the number of adolescent bariatric surgery programs increases, continued research and long-term outcome data need to be collected and shared to base future treatment decisions.
在过去30年里,美国青少年肥胖症的患病率急剧上升。减肥手术正成为肥胖青少年可行的治疗选择。每年进行的手术数量在增加,而且这一趋势可能会持续下去。青少年患者给临床医生带来了独特的挑战。目前有针对青少年肥胖症患者治疗的最佳实践建议和循证营养指南。对当前文献进行了综述,以讨论青少年患者的减肥手术和营养问题。研究表明,大多数肥胖青少年会成长为肥胖成年人,从而增加他们患严重且使人衰弱的健康问题的风险。建议将手术候选人转介到一个有多学科团队的医疗机构,该团队在满足青少年独特的身体和心理需求方面经验丰富。青少年肥胖症患者具体的营养问题包括术前教育途径、术后饮食进展、女性生殖、对维生素/补充剂建议的依从性、实验室检查以及长期监测。医学文献报道了减肥手术对重度肥胖青少年的积极效果。在将手术作为一种选择提供之前,必须解决青少年的独特因素。多学科临床团队在考虑青少年的手术候选资格时,必须考虑他们的认知、社会和情感发展。随着青少年减肥手术项目数量的增加,需要收集和分享持续的研究以及长期结果数据,以便为未来的治疗决策提供依据。