{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T17:20:15Z","timestamp":1768584015956,"version":"3.49.0"},"reference-count":70,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2021,5,9]],"date-time":"2021-05-09T00:00:00Z","timestamp":1620518400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Despite worldwide public attention and intense medical efforts, the prevalence of severe morbid obesity in children and adolescents is still rising. Similar to adults, excess adipose tissue triggers multiple immunological and metabolic pathways leading to serious co-morbidities such as impaired glucose tolerance or even type 2 diabetes (T2D), dyslipidemia, arterial hypertension, non-alcoholic fatty liver disease, and hyperuricemia. The management of severe childhood obesity requires a life-long multidisciplinary approach with a combination of lifestyle changes, nutrition, and medications. Standardized life-style intervention programs remain the first-line treatment for morbid obese children and adolescents, but unfortunately reveal limited long-term success. In such cases, metabolic bariatric surgery (MBS) has evolved from being a controversial issue to being included in distinct recommendations. According to the American Society for Metabolic and Bariatric Surgery (ASMBS) Pediatric Committee, indications for bariatric surgery in adolescence must follow very strict criteria. Adolescents with class II obesity (BMI &gt; 120% of the 95th percentile) and a diagnosed co-morbidity or with class III obesity (BMI \u2265 140% of the 95th percentile) should be considered for MBS. These interventions represent high-risk operations, and adolescents should be treated in specialized, multidisciplinary high-volume obesity centers with long-term follow-up programs. The Roux-en-Y gastric bypass (RYGB) remains the gold standard of all malabsorptive procedures. Laparoscopic sleeve gastrectomy (LSG), which the authors pioneered as a stand-alone procedure in morbidly obese adolescents in 2008, has become the most commonly performed operation in morbidly obese adolescents at present. Recent literature proves that MBS is safe and effective in morbidly obese adolescents. Mid-term data have revealed significant improvement or even resolution of major co-morbidities. Thus, MBS for the treatment of morbidly obese adolescents has evolved from being a controversial issue to being included in distinct recommendations by several medical societies as a therapeutic strategy to reduce severe co-morbidities potentially causing end-organ damage in adulthood.<\/jats:p>","DOI":"10.3390\/children8050372","type":"journal-article","created":{"date-parts":[[2021,5,9]],"date-time":"2021-05-09T21:32:46Z","timestamp":1620595966000},"page":"372","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Update on Metabolic Bariatric Surgery for Morbidly Obese Adolescents"],"prefix":"10.3390","volume":"8","author":[{"given":"Holger","family":"Till","sequence":"first","affiliation":[{"name":"Department of Pediatric and Adolescent Surgery, Medical University of Graz, 8036 Graz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oliver","family":"Mann","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4770-3144","authenticated-orcid":false,"given":"Georg","family":"Singer","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Adolescent Surgery, Medical University of Graz, 8036 Graz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susann","family":"Weihrauch-Bl\u00fcher","sequence":"additional","affiliation":[{"name":"Clinic for Pediatrics I, Pediatric Endocrinology, University Hospital Halle (Saale), 06120 Halle (Saale), Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,9]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2021, March 28). Fact Sheet on Obesity and Overweight. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/obesity-and-overweight."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1016\/j.metabol.2013.11.012","article-title":"Bariatric surgery in severely obese adolescents improves major comorbidities including hyperuricemia","volume":"63","author":"Oberbach","year":"2014","journal-title":"Metabolism"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1016\/j.soard.2018.03.019","article-title":"ASMBS pediatric metabolic and bariatric surgery guidelines, 2018","volume":"14","author":"Pratt","year":"2018","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.1007\/s11695-020-05096-w","article-title":"Bariatric Surgery Is Protective Against Renal Function Decline in Severely Obese Patients in the Long-Term","volume":"31","author":"Lautenbach","year":"2021","journal-title":"Obes. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1002\/oby.22725","article-title":"Thirty-Year Risk of Cardiovascular Disease Events in Adolescents with Severe Obesity","volume":"28","author":"Ryder","year":"2020","journal-title":"Obesity"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1542\/peds.2011-1082","article-title":"Prevalence of cardiovascular disease risk factors among US adolescents, 1999\u20132008","volume":"129","author":"May","year":"2012","journal-title":"Pediatrics"},{"key":"ref_7","first-page":"125","article-title":"Psychological consequences of childhood obesity: Psychiatric comorbidity and prevention","volume":"7","author":"Rankin","year":"2016","journal-title":"Adolesc. Health Med. Ther."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1111\/obr.12316","article-title":"Childhood obesity as a predictor of morbidity in adulthood: A systematic review and meta-analysis","volume":"17","author":"Llewellyn","year":"2016","journal-title":"Obes. Rev."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.metabol.2018.12.001","article-title":"Childhood obesity: Increased risk for cardiometabolic disease and cancer in adulthood","volume":"92","author":"Schwarz","year":"2019","journal-title":"Metabolism"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1007\/s11684-018-0640-1","article-title":"Epidemic obesity in children and adolescents: Risk factors and prevention","volume":"12","author":"Lee","year":"2018","journal-title":"Front. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/j.soard.2017.10.003","article-title":"Weight loss after bariatric surgery in obese adolescents: A systematic review and meta-analysis","volume":"14","author":"Pedroso","year":"2018","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1007\/s11894-019-0691-8","article-title":"Bariatric Surgery in Children: Indications, Types, and Outcomes","volume":"21","author":"Thenappan","year":"2019","journal-title":"Curr. Gastroenterol. Rep."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1007\/s13679-017-0277-4","article-title":"What Is the Evidence for Paediatric\/Adolescent Bariatric Surgery?","volume":"6","author":"Durkin","year":"2017","journal-title":"Curr. Obes. Rep."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"150890","DOI":"10.1016\/j.sempedsurg.2020.150890","article-title":"Preoperative considerations for the pediatric patient undergoing metabolic and bariatric surgery","volume":"29","author":"Pratt","year":"2020","journal-title":"Semin. Pediatr. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1159\/000355480","article-title":"Interdisciplinary European guidelines on metabolic and bariatric surgery","volume":"6","author":"Fried","year":"2013","journal-title":"Obes. Facts"},{"key":"ref_16","unstructured":"(2021, March 28). AWMF-Leitlinie Chirurgie der Adipositas Und metabolischer Erkrankungen, Registernummer 088\u2014001, Entwicklungsstufe S3, Version 2.3, February 2018. Available online: https:\/\/www.awmf.org\/uploads\/tx_szleitlinien\/088-001l_S3_Chirurgie-Adipositas-metabolische-Erkrankugen_2018-02.pdf."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1007\/s10880-020-09717-5","article-title":"Psychopathology and Adolescent Bariatric Surgery: A Topical Review to Support Psychologists in Assessment and Treatment Considerations","volume":"27","author":"Burton","year":"2020","journal-title":"J. Clin. Psychol. Med. Settings"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1016\/j.soard.2019.12.010","article-title":"Parental attitudes toward bariatric surgery in adolescents with obesity","volume":"16","author":"Singh","year":"2020","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1542\/peds.2005-0910","article-title":"Parents\u2019 perceptions of their child\u2019s weight and health","volume":"117","author":"Eckstein","year":"2006","journal-title":"Pediatrics"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1362","DOI":"10.1038\/oby.2003.184","article-title":"Childhood obesity: Do parents recognize this health risk?","volume":"11","author":"Etelson","year":"2003","journal-title":"Obes. Res."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Grant, H.M., Perez-Caraballo, A., Romanelli, J.R., and Tirabassi, M.V. (2021). Metabolic and bariatric surgery is likely safe, but underutilized in adolescents aged 13\u201317 years. Surg. Obes. Relat. Dis.","DOI":"10.1016\/j.soard.2021.02.030"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1007\/s11695-008-9543-6","article-title":"Efficacy of laparoscopic sleeve gastrectomy (LSG) as a stand-alone technique for children with morbid obesity","volume":"18","author":"Till","year":"2008","journal-title":"Obes. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"138","DOI":"10.14310\/horm.2002.1230","article-title":"Laparoscopic sleeve gastrectomy in morbidly obese patients. Technique and short term results","volume":"8","author":"Kiriakopoulos","year":"2009","journal-title":"Hormones"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1007\/s11695-010-0145-8","article-title":"A review of laparoscopic sleeve gastrectomy for morbid obesity","volume":"20","author":"Shi","year":"2010","journal-title":"Obes. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1055\/s-2008-1038356","article-title":"Laparoscopic sleeve gastrectomy achieves substantial weight loss in an adolescent girl with morbid obesity","volume":"18","author":"Till","year":"2008","journal-title":"Eur. J. Pediatr. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1056\/NEJMoa1506699","article-title":"Weight Loss and Health Status 3 Years after Bariatric Surgery in Adolescents","volume":"374","author":"Inge","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1111\/obr.12037","article-title":"Bariatric surgery for obese children and adolescents: A systematic review and meta-analysis","volume":"14","author":"Black","year":"2013","journal-title":"Obes. Rev."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1038\/ijo.2017.193","article-title":"Factors associated with long-term weight-loss maintenance following bariatric surgery in adolescents with severe obesity","volume":"42","author":"Ryder","year":"2018","journal-title":"Int. J. Obes."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1007\/s11695-009-9895-6","article-title":"Behavioral predictors of weight regain after bariatric surgery","volume":"20","author":"Odom","year":"2010","journal-title":"Obes. Surg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2519","DOI":"10.1001\/jama.1990.03450190051027","article-title":"Ten-year follow-up of behavioral, family-based treatment for obese children","volume":"264","author":"Epstein","year":"1990","journal-title":"JAMA"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1016\/j.soard.2012.03.007","article-title":"Changes in weight and co-morbidities among adolescents undergoing bariatric surgery: 1-year results from the Bariatric Outcomes Longitudinal Database","volume":"9","author":"Messiah","year":"2013","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1016\/j.soard.2014.01.020","article-title":"Co-morbidity resolution in morbidly obese children and adolescents undergoing sleeve gastrectomy","volume":"10","author":"Alqahtani","year":"2014","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1579","DOI":"10.1038\/ijo.2017.141","article-title":"Lipid changes 8 years post gastric bypass in adolescents with severe obesity (FABS-5+ study)","volume":"41","author":"Shah","year":"2017","journal-title":"Int. J. Obes."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Aminian, A., Zajichek, A., Arterburn, D.E., Wolski, K.E., Brethauer, S.A., Schauer, P.R., Kattan, M.W., and Nissen, S.E. (2019). Association of Metabolic Surgery With Major Adverse Cardiovascular Outcomes in Patients with Type 2 Diabetes and Obesity. JAMA.","DOI":"10.1001\/jama.2019.14231"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Benotti, P.N., Wood, G.C., Carey, D.J., Mehra, V.C., Mirshahi, T., Lent, M.R., Petrick, A.T., Still, C., Gerhard, G.S., and Hirsch, A.G. (2017). Gastric Bypass Surgery Produces a Durable Reduction in Cardiovascular Disease Risk Factors and Reduces the Long-Term Risks of Congestive Heart Failure. J. Am. Heart Assoc., 6.","DOI":"10.1161\/JAHA.116.005126"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2613","DOI":"10.2337\/dc12-0193","article-title":"Cardiovascular events after bariatric surgery in obese subjects with type 2 diabetes","volume":"35","author":"Romeo","year":"2012","journal-title":"Diabetes Care"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1001\/jama.2011.1914","article-title":"Bariatric surgery and long-term cardiovascular events","volume":"307","author":"Sjostrom","year":"2012","journal-title":"JAMA"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1097\/01.sla.0000089851.41115.1b","article-title":"Effect of laparoscopic Roux-en Y gastric bypass on type 2 diabetes mellitus","volume":"238","author":"Schauer","year":"2003","journal-title":"Ann. Surg."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1712","DOI":"10.1007\/s11695-019-04377-3","article-title":"Temporal Effects of Bariatric Surgery on Adipokines, Inflammation and Oxidative Stress in Subjects with Impaired Glucose Homeostasis at 4 Years of Follow-up","volume":"30","author":"Min","year":"2020","journal-title":"Obes. Surg."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Unamuno, X., Izaguirre, M., Gomez-Ambrosi, J., Rodriguez, A., Ramirez, B., Becerril, S., Valenti, V., Moncada, R., Silva, C., and Salvador, J. (2019). Increase of the Adiponectin\/Leptin Ratio in Patients with Obesity and Type 2 Diabetes after Roux-en-Y Gastric Bypass. Nutrients, 11.","DOI":"10.3390\/nu11092069"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e3045","DOI":"10.1002\/dmrr.3045","article-title":"Roux-en-Y gastric bypass surgery alters serum metabolites and fatty acids in patients with morbid obesity","volume":"34","author":"Wijayatunga","year":"2018","journal-title":"Diabetes Metab Res. Rev."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/j.jadohealth.2017.12.021","article-title":"A Multisite 2-Year Follow Up of Psychopathology Prevalence, Predictors, and Correlates Among Adolescents Who Did or Did Not Undergo Weight Loss Surgery","volume":"63","author":"Hunsaker","year":"2018","journal-title":"J. Adolesc Health"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1016\/j.soard.2016.02.001","article-title":"Characteristics of adolescents with poor mental health after bariatric surgery","volume":"12","author":"Jarvholm","year":"2016","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1016\/j.soard.2019.12.015","article-title":"Suicidal thoughts and behaviors in adolescents who underwent bariatric surgery","volume":"16","author":"Zeller","year":"2020","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1002\/erv.2406","article-title":"Suicidal Ideation and Behaviours Among Adolescents Receiving Bariatric Surgery: A Case-Control Study","volume":"23","author":"McPhee","year":"2015","journal-title":"Eur. Eat. Disord. Rev."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1007\/s11695-007-9162-7","article-title":"Pregnancy after gastric bypass surgery in adolescents","volume":"17","author":"Roehrig","year":"2007","journal-title":"Obes. Surg."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1007\/s11695-015-1581-2","article-title":"Bariatric surgery in morbidly obese adolescents: A systematic review and meta-analysis","volume":"25","author":"Paulus","year":"2015","journal-title":"Obes. Surg."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1146\/annurev-nutr-071812-161225","article-title":"Nutrient deficiencies after gastric bypass surgery","volume":"33","author":"Saltzman","year":"2013","journal-title":"Annu. Rev. Nutr."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1007\/s11892-010-0118-2","article-title":"Bariatric surgery as treatment for type 2 diabetes","volume":"10","author":"Blackburn","year":"2010","journal-title":"Curr. Diab. Rep."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1056\/NEJMoa1600869","article-title":"Bariatric Surgery versus Intensive Medical Therapy for Diabetes\u20145-Year Outcomes","volume":"376","author":"Schauer","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1007\/s11695-008-9687-4","article-title":"Bariatric surgery, safety and type 2 diabetes","volume":"19","author":"Spanakis","year":"2009","journal-title":"Obes. Surg."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Anguita-Ruiz, A., Bustos-Aibar, M., Plaza-D\u00edaz, J., Mendez-Gutierrez, A., Alcal\u00e1-Fdez, J., Aguilera, C.M., and Ruiz-Ojeda, F.J. (2021). Omics Approaches in Adipose Tissue and Skeletal Muscle Addressing the Role of Extracellular Matrix in Obesity and Metabolic Dysfunction. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22052756"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"2182","DOI":"10.1007\/s00125-020-05212-6","article-title":"Multi-layered epigenetic regulation of IRS2 expression in the liver of obese individuals with type 2 diabetes","volume":"63","author":"Krause","year":"2020","journal-title":"Diabetologia"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"547","DOI":"10.7326\/0003-4819-142-7-200504050-00013","article-title":"Meta-analysis: Surgical treatment of obesity","volume":"142","author":"Maggard","year":"2005","journal-title":"Ann. Intern. Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1381\/0960892042387057","article-title":"Bariatric surgery worldwide 2003","volume":"14","author":"Buchwald","year":"2004","journal-title":"Obes. Surg."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1111\/obr.12169","article-title":"Duodenal switch versus Roux-en-Y gastric bypass for morbid obesity: Systematic review and meta-analysis of weight results, diabetes resolution and early complications in single-centre comparisons","volume":"15","author":"Hedberg","year":"2014","journal-title":"Obes. Rev."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1007\/s11695-014-1460-2","article-title":"The long-term effects of bariatric surgery for type 2 diabetes: Systematic review and meta-analysis of randomized and non-randomized evidence","volume":"25","author":"Yu","year":"2015","journal-title":"Obes. Surg."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1038\/oby.2008.577","article-title":"Best practice updates for pediatric\/adolescent weight loss surgery","volume":"17","author":"Pratt","year":"2009","journal-title":"Obesity"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"e746","DOI":"10.1542\/peds.2010-0412","article-title":"Trends and outcomes of adolescent bariatric surgery in California, 2005\u20132007","volume":"126","author":"Jen","year":"2010","journal-title":"Pediatrics"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1001\/jama.2010.99","article-title":"Surgical treatment of obesity in adolescence","volume":"303","author":"Livingston","year":"2010","journal-title":"JAMA"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1097\/SLA.0b013e31818702f4","article-title":"Systematic review and meta-analysis of bariatric surgery for pediatric obesity","volume":"248","author":"Treadwell","year":"2008","journal-title":"Ann. Surg."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1001\/jama.2010.81","article-title":"Laparoscopic adjustable gastric banding in severely obese adolescents: A randomized trial","volume":"303","author":"Sawyer","year":"2010","journal-title":"JAMA"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1988","DOI":"10.1016\/S0140-6736(07)61844-3","article-title":"Clinical update: Bariatric surgery","volume":"370","author":"Korenkov","year":"2007","journal-title":"Lancet"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.jpedsurg.2005.10.017","article-title":"One-year outcomes of Roux-en-Y gastric bypass for morbidly obese adolescents: A multicenter study from the Pediatric Bariatric Study Group","volume":"41","author":"Lawson","year":"2006","journal-title":"J. Pediatr. Surg."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1097\/01.SLA.0000071560.76194.11","article-title":"Diabetes and hypertension in severe obesity and effects of gastric bypass-induced weight loss","volume":"237","author":"Sugerman","year":"2003","journal-title":"Ann. Surg."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/j.soard.2008.08.007","article-title":"Disappointing mid-term results after laparoscopic gastric banding in young patients","volume":"5","author":"Lanthaler","year":"2009","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1016\/j.jpeds.2015.08.020","article-title":"Insulin Sensitivity and beta-Cell Function Improve after Gastric Bypass in Severely Obese Adolescents","volume":"167","author":"Inge","year":"2015","journal-title":"J. Pediatr."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1001\/jamapediatrics.2013.4296","article-title":"Perioperative outcomes of adolescents undergoing bariatric surgery: The Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) study","volume":"168","author":"Inge","year":"2014","journal-title":"JAMA Pediatr."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1038\/nrendo.2010.167","article-title":"Morbid obesity in pediatric diabetes mellitus: Surgical options and outcomes","volume":"6","author":"Brandt","year":"2010","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Ogle, S.B., Dewberry, L.C., Jenkins, T.M., Inge, T.H., Kelsey, M., Bruzoni, M., and Pratt, J.S.A. (2021). Outcomes of Bariatric Surgery in Older Versus Younger Adolescents. Pediatrics, 147.","DOI":"10.1542\/peds.2020-024182"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/8\/5\/372\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:58:31Z","timestamp":1760162311000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/8\/5\/372"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,9]]},"references-count":70,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,5]]}},"alternative-id":["children8050372"],"URL":"https:\/\/doi.org\/10.3390\/children8050372","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,9]]}}}