CHILDHOOD OBESITY AND FUTURE CARDIOVASCULAR RISK: THE ROLE OF BARIATRIC SURGERY IN SEVERE CASES

Abstract

Introduction: Childhood obesity has established itself as a major public health concern due to its significant impact on long-term health, particularly in relation to cardiovascular risk. Children and adolescents with severe obesity face not only immediate physical challenges, but also an elevated risk of developing chronic diseases in adulthood, such as type 2 diabetes, hypertension and heart disease. Bariatric surgery has emerged as a treatment option for severe cases of pediatric obesity, showing promising results in weight loss and reducing associated cardiovascular risks. However, the procedure is not without risks, and its application in young patients raises ethical and legal questions, in addition to requiring continuous and multidisciplinary monitoring. Objective: The objective of this systematic literature review was to evaluate the effectiveness, risks and implications of bariatric surgery in children and adolescents with severe obesity, focusing on the long-term impacts on cardiovascular health and quality of life, based on studies and articles published in the last 10 years. Methodology: The methodology of this review was structured with based on the PRISMA checklist. The databases used included PubMed, Scielo and Web of Science, using descriptors such as "childhood obesity", "bariatric surgery", "cardiovascular risk", "long-term results" and "psychological impact". Articles that addressed surgical interventions in pediatric patients with severe obesity were considered. As inclusion criteria, studies were selected that involved samples of children and adolescents, that had at least one year of post-surgical follow-up and that were published in peer-reviewed journals. Among the exclusion criteria, articles that dealt exclusively with adults, studies with less than 10 participants and research that did not present follow-up data were disregarded. Results: The results indicated that bariatric surgery contributed significantly to reducing weight and comorbidities associated with obesity, especially with regard to improving cardiovascular risk indices. However, nutritional complications and the need for ongoing psychological support have also been reported. Studies have highlighted the importance of rigorous postoperative monitoring and multidisciplinary support to maximize benefits and minimize risks. Conclusion: It was concluded that, although bariatric surgery offers substantial benefits for children and adolescents with severe obesity, its application must be carefully evaluated, considering both clinical aspects and ethical and legal challenges. Long-term success depends on an integrated approach that involves ongoing nutritional, psychological and social support.