LONG-TERM CLINICAL MANAGEMENT OF BARIATRIC SURGERY IN ADOLESCENTS WITH SEVERE OBESITY

Abstract

Severe obesity in adolescents represents a serious public health problem, associated with several comorbidities and with a significant impact on quality of life. Bariatric surgery has proven to be an effective alternative for the treatment of morbid obesity in adults, however, its use in adolescents is still controversial and requires further studies on its long-term effects. The present systematic review aimed to evaluate the scientific literature on the long-term clinical management of adolescents undergoing bariatric surgery, seeking to identify the best practices and challenges involved in this process. Objective: The objective of this systematic review was to synthesize the available scientific evidence on the long-term clinical management of bariatric surgery in adolescents with severe obesity, focusing on clinical, metabolic and psychological outcomes, as well as complications and the need for multidisciplinary monitoring. Methodology: A systematic review of the literature was carried out, following the recommendations of the PRISMA statement. The PubMed, Scielo and Web of Science databases were searched using the following descriptors: “adolescents”, “bariatric surgery”, “long-term outcomes”, “complications” and “follow-up”. The search was limited to articles published in the last 10 years. The studies were selected based on the following inclusion criteria: randomized clinical trials and observational studies with adolescents (13 to 19 years old) undergoing bariatric surgery, with a minimum follow-up of 2 years. Studies with duplication of data, systematic reviews and meta-analyses, studies focusing on other populations and studies that did not report data on long-term clinical management were excluded. Results: The results demonstrated that bariatric surgery promoted significant weight loss and improvement in comorbidities such as type 2 diabetes mellitus and high blood pressure. However, some long-term complications have been identified, such as nutritional deficiencies and psychological changes. The need for multidisciplinary monitoring, including nutritionists, psychologists and endocrinologists, was emphasized in all studies. Conclusion: Bariatric surgery can be an effective option for treating severe obesity in adolescents, promoting significant weight loss and improving comorbidities. However, long-term follow-up is essential to identify and treat complications, ensure adherence to treatment and promote adolescents' quality of life. More high-quality studies are needed to evaluate the long-term effects of bariatric surgery in adolescents, focusing on different surgical techniques and populations.