{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T22:40:37Z","timestamp":1778712037353,"version":"3.51.4"},"reference-count":51,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,6,22]],"date-time":"2025-06-22T00:00:00Z","timestamp":1750550400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100004423","name":"World Health Organization","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004423","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007843","name":"Direktoratet for Utviklingssamarbeid","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007843","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004441","name":"Styrelsen f\u00f6r Internationellt Utvecklingssamarbete","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004441","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Obesity Reviews"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Childhood obesity is a global health challenge linked to metabolic, cardiovascular, and psychosocial complications. While lifestyle interventions represent the key strategy for obesity management, metabolic and bariatric surgery (MBS) has emerged as a therapeutic option for severe obesity. This systematic review with meta\u2010analysis assessed the effectiveness and safety of MBS and weight management devices in children and adolescents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included randomized and prospective controlled cohort studies assessing MBS or weight management devices in children and adolescents with obesity, searching PubMed, Embase, Cochrane Library, ClinicalTrials.gov, and WHO International Clinical Trials Registry through January 2025. Critical outcomes included body mass index (BMI) and weight reduction, adverse events, and incidence or severity of obesity\u2010related outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seven studies (three RCTs and four non\u2010RCTs), all involving adolescents undergoing MBS, were included. No studies evaluated children or devices. Meta\u2010analysis showed that compared with lifestyle intervention, MBS reduced BMI by 11.7\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      (95% CI: \u201313.2 to \u221210.1; two RCTs,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009100) and 14.5\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      (95% CI: \u201315.7 to \u221213.3; three non\u2010RCTs,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009307), and weight by 20.9% (95% CI: \u201323.6 to \u221218.1; three RCTs,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009152) and 31.2% (95% CI: \u201334.3 to \u221228.0; two non\u2010RCTs,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009173). Certainty of evidence was low. One non\u2010RCT comparing Roux\u2010en\u2010Y gastric bypass and sleeve gastrectomy found similar outcomes. Both RCTs and non\u2010RCTs reported improvements in obesity\u2010related outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although MBS leads to substantial weight loss and health benefits in adolescents, the risk of complications underscores the need for careful patient selection, surgical expertise, and comprehensive postoperative care.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      PROSPERO registration: CRD42023438469\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/obr.13974","type":"journal-article","created":{"date-parts":[[2025,6,22]],"date-time":"2025-06-22T20:13:46Z","timestamp":1750623226000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Surgery and Minimally Invasive Devices for the Treatment of Obesity in Children and Adolescents: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1189-9907","authenticated-orcid":false,"given":"Francesco\u00a0Maria","family":"Carrano","sequence":"first","affiliation":[{"name":"Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology St Andrea Hospital, Sapienza University  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleonora","family":"Allocati","sequence":"additional","affiliation":[{"name":"Center for Health Regulatory Policies Istituto di Ricerche Farmacologiche Mario Negri IRCCS  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rita","family":"Banzi","sequence":"additional","affiliation":[{"name":"Center for Health Regulatory Policies Istituto di Ricerche Farmacologiche Mario Negri IRCCS  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4112-2787","authenticated-orcid":false,"given":"Eugenia","family":"Romano","sequence":"additional","affiliation":[{"name":"Institute of Psychiatry, Psychology and Neuroscience King's College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2137-5974","authenticated-orcid":false,"given":"Valeria","family":"Calcaterra","sequence":"additional","affiliation":[{"name":"Department of Pediatrics \u201cVittore Buzzi\u201d Children's Hospital  Milan Italy"},{"name":"Department of Internal Medicine and Therapeutics University of Pavia  Pavia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giacomo","family":"Piatto","sequence":"additional","affiliation":[{"name":"Department of General Surgery Ospedale di Montebelluna  Montebelluna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Sartori","sequence":"additional","affiliation":[{"name":"Department of General Surgery Ospedale di Montebelluna  Montebelluna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Inama","sequence":"additional","affiliation":[{"name":"General and Mininvasive Surgery Department Pederzoli Hospital  Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maurizio","family":"De\u00a0Luca","sequence":"additional","affiliation":[{"name":"Department of General Surgery Rovigo Hospital  Rovigo Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Di\u00a0Lorenzo","sequence":"additional","affiliation":[{"name":"Department of Surgery Sapienza University of Rome  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Gerardi","sequence":"additional","affiliation":[{"name":"Center for Health Regulatory Policies Istituto di Ricerche Farmacologiche Mario Negri IRCCS  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,22]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2022-060640"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/10408398.2020.1823813"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13679-021-00439-9"},{"key":"e_1_2_11_5_1","unstructured":"WHO Obesity World Health Organization. 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