Bariatric Surgery for Older Children and Teens with CognitiveImpairment or Developmental Disabilityby Lewis First MD, MS, Editor in Chief, Pediatrics

Bariatric surgery is more than just about the surgery. It requires pre-operative planning and counseling todetermine whether someone is motivated to begin to lose the weight before the procedure as a way of indirectlyindicating if they can keep weight from reaccumulating after the operation. It also requires attention to properdiet, exercise, and other prevention strategies to keep the weight from coming back. Thus one might questionwhether an older child or teen who has a cognitive impairment or developmental disability (CI/DD) is a goodcandidate for bariatric surgery such as a sleeve gastrectomy. Hornack et al. (10.1542/peds.2018-2908) studiedhow effective bariatric surgery is for obese youth compared to youth without CI/DD and found no post-opoutcome. In fact, children with CI/DD who underwent a gastric sleeve bariatric procedure lost more weight overtime and were able to keep the weight from coming back.

So what's the take-away from this study? We asked pediatric and bariatric surgeon Dr. Marc Michalsky(10.1542/peds.2018-4112) from Nationwide Children's Hospital in Columbus, Ohio to share his thoughts in anaccompanying commentary.  While Dr. Michalsky notes the small sample size and the short follow-up periodcaptured, he also notes that the support services that are provided to these youth by their caregivers and otherprovider services may make compliance with post-op care and diet easier. If you have ever referred a patientwith CI/DD for bariatric surgery only to find they were denied because of their disability, please show thatbariatric team and that patient and family this study and commentary so they can undergo the surgery whichappears to be a great way to lose the weight and keep it off. Weigh into this study to learn more.

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