Original articlePerspectives on pediatric bariatric surgery: identifying barriers to referral
Section snippets
Methods
With institutional review board approval, a survey was distributed to all physicians at Mayo Clinic Rochester who had clinical contact with children, including general pediatricians, pediatric specialists, family practitioners, and pediatric psychiatrists. The survey used a Likert scale to assess their perspectives on childhood (age <13 y) and adolescent (age 13–18 y) obesity in 3 different areas: (1) the severity of the problem, (2) physician-specific practices and outcomes in treating
Prevalence of overweight, obesity, and weight-related co-morbidities
All 61 respondents believed strongly that childhood and adolescent obesity is a serious health problem, and 50 recognized an increase in the incidence during a mean period of 15 years (range 3–25). Of the 61 physicians, 35 reported that <20% of children they saw were overweight (BMI <95th percentile but ≥85th percentile for same age and gender), and another 26 reported that 20–50% of children were overweight (Fig. 1a). In contrast, 46 reported that nearly 20–50% of adolescents were overweight
Discussion
Physicians directly involved in the care of pediatric patients are aware of the growing obesity epidemic among children and adolescents. They clearly recognize the very serious complications of obesity and the importance of sustainable excess weight loss to prevent disease progression and even achieve resolution of weight-related co-morbidities. Most of the physicians participating in the present study had implemented nonoperative weight loss measures in their practice. However, despite the
Conclusion
Physicians caring for children are aware of the growing epidemic of childhood and adolescent overweight/obesity. The current nonoperative options for weight loss are failing, but many providers still have a reluctance to refer patients for a bariatric evaluation. Efforts are needed to evaluate and document the short- and long-term safety and efficacy of bariatric procedures for appropriately selected pediatric patients, as well as the utility of a thorough evaluation in multidisciplinary,
Disclosures
The authors claim no commercial associations that might be a conflict of interest in relation to this article.
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