Laparoscopic sleeve gastrectomy is an effective and safe procedure for use in young patients, according to a group of researchers from Saudi Arabia. Results of their retrospective study show that, in 108 patients aged 5–21 years, this surgery led to substantial excess weight loss in more than 90% of patients and most patients experienced a reduction in the prevalence of obesity comorbidities.

“I don't think it is ethical to deny obesity treatment to those who need it just because they are children,” says lead researcher Aayed Alqahtani of King Saud University, Riyadh. “When I see the positive changes in their lives following surgery, I recognize the benefit of such an approach,” he adds.

While previous studies have demonstrated the benefits of bariatric surgery in adults, the suitability of this approach for children has been a subject of debate, and surgery is often rejected in favour of dietary and behavioural interventions. However, while these lifestyle changes can have substantial success in treating children with mild to moderate obesity, they are less successful when applied to children with severe obesity. Therefore, several studies have been undertaken in the past decade to examine the effectiveness and safety of surgery to treat young people with obesity.

“This report details surgery outcomes of a sizeable number of the youngest paediatric patients ever reported in the bariatric surgery literature,” comments Thomas Inge of Cincinnati Children's Hospital Medical Center, Ohio, USA, who was not involved in the study. “The comorbidity change information that the researchers report is critically needed,” he adds, “as the adverse health effects of obesity are what should drive such intensive therapy.”

The investigators found that most of their patients had measurable improvements in known obesity comorbidities, such as dyslipidaemia, hypertension, prehypertension, obstructive sleep apnea, diabetes mellitus and prediabetes mellitus (rates of resolution 70%, 75%, 83%, 91%, 94% and 100%, respectively). None of the patients experienced serious complications and no deaths resulted from surgery.