Bariatric Surgery Underutilization in Young Postadolescent Population With Obesity

Purpose

Bariatric surgery is an established treatment option for adolescent patients struggling with obesity, yet it remains underutilized. We aimed to gain insight into patients’ views of bariatric surgery and identify the strategies for improved utilization of the procedure in early postadolescence.

Methods

The electronic medical records of patients diagnosed with obesity at a tertiary medical center, ages 18–22 years old, were examined. Patients participated in a follow-up survey related to obesity treatment.

Findings

While 20% of patients had BMIs ≥ 35 kg/m² in adolescence, more than half (54%) of patients with obesity reached BMIs ≥ 35 kg/m² after 18 y/o, thus potentially qualifying for bariatric surgery. A minority of patients (6/280, 2%) underwent bariatric surgery and experienced substantial weight loss in early postadolescence. Most remaining surgery-eligible patients (141/152, 93%) noted a BMI increase (0.05–28.6 kg/m²) during the immediate young adult study period without surgical intervention. While 66.7% of patients who recall receiving surgery-specific counseling would consider surgery as a part of their treatment, only 4.6% of patients who did not recall counseling would consider undergoing bariatric surgery.

Implications

In the absence of provider referral during adolescence, bariatric surgery remains underutilized in early postadolescence. Provider counseling is an essential component of patients’ willingness to consider bariatric surgery.