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Nutritional Strategy for Adolescents Undergoing Bariatric Surgery: Report of a Working Group of the Nutrition Committee of NASPGHAN/NACHRI

Fullmer, Michell A.*; Abrams, Stephanie H.; Hrovat, Kathleen; Mooney, Lori§; Scheimann, Ann O.||; Hillman, Jennifer B.; Suskind, David L.

Journal of Pediatric Gastroenterology & Nutrition: January 2012 - Volume 54 - Issue 1 - p 125–135
doi: 10.1097/MPG.0b013e318231db79
Clinical Guidelines

ABSTRACT: Surgical options for the treatment of adolescent obesity have been gaining popularity. Adolescent patients present a particular challenge to clinicians, secondary to age-related issues, revolving around both mental and physical growth. These age-related issues require a unique approach to nutritional intervention for adolescents undergoing bariatric surgery as opposed to standardized approaches for adults. Despite the increasing numbers of adolescents undergoing obesity surgery, evidence-based nutritional guidelines have yet to be published. The goal of this document is to provide the clinician with recommendations on how to assess, educate, nourish, and monitor the adolescent who has undergone obesity surgery. A multidisciplinary panel composed of 3 pediatric gastroenterologists, 1 psychologist, and 3 registered dietitians from the Nutrition Committee for the North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition and National Association of Children's Hospitals and Related Institutions, with experience in nutrition and adolescent weight loss surgery, reviewed the medical literature for evidence-based practice for nutritional strategies for patients undergoing bariatric surgery. In addition to this group, an adolescent medicine physician was consulted for matters related to reproductive health. The present article presents a consensus of recommendations based on a review of the literature. In areas for which there was a lack of evidence to support the recommendations, best-practice guidelines were used. The present article provides the clinician with an overview of the nutritional concerns for adolescent patients undergoing obesity surgery. These guidelines address the preoperative educational pathway, the postoperative diet progression, recognition of disordered eating, guidelines for female reproductive issues, and assistance for the adolescent in a school/college environment.

*A.I. Dupont Children's Hospital, Wilmington, DE

Texas Children's Hospital, Houston, TX

Cincinnati Children's Hospital, Cincinnati, OH

§Nationwide Children's Hospital, Columbus OH

||Johns Hopkins Hospital, Baltimore, MD

Seattle Children's Hospital, University of Washington, Seattle, WA.

Address correspondence and reprint requests to David Suskind, MD (e-mail: david.suskind@seattlechildrens.org).

Received 15 May, 2011

Accepted 18 July, 2011

The authors report no conflict of interests.

Copyright 2012 by ESPGHAN and NASPGHAN