Adjustable gastric banding surgery in morbidly obese adolescents: experiences with eight patients.
BACKGROUND
Excessive obesity in children and adolescents is increasing in western countries all over the world. Treatment of those young subjects is extremely difficult. In cases who do not respond in any regard to conservative treatment regimens, it is worthwhile to also offer bariatric surgical procedures.


METHODS
In eight young subjects with a mean age of 16.0+/-1.3 y, mean BMI 49.1+/-5.2 who where totally resistant against different therapeutic regimens, we performed adjustable laparoscopic banding surgery. Psychological tests were carried out to find out if there were any psychological disturbances. In all patients, the depression inventory for adolescents (DIKJ) and clinical interviews were carried out.


RESULTS
No complications were seen; mean follow-up of 10.5+/-6.0 months showed a weight loss of 25+/-6.5 kg. All adolescents felt for the first time that it was possible to lose weight and were very happy about their body attitude. They were able to adhere to a strict dietary regimen, which allowed them to eat without any hunger problems. It was observed that most of these patients have depressive symptoms and a very low self-esteem. Some patients suffer from nervous anxiety, poor peer acceptance, less athletic competence or forms of victimisation too.


CONCLUSIONS
From these results, we conclude that laparoscopic gastric banding surgery seems to be a method that could be offered to morbidly obese adolescents. However, long-term follow-up is essential and psychological problems should be carefully studied.
Widhalm
K
K
Division of Nutrition and Metabolism, Department of Pediatrics, Medical University of Vienna, A-1090 Vienna, Austria. kurt.widhalm@meduniwien.ac.at
Dietrich
S
S
Prager
G
G
D000293:Adolescent; D003863:Depression / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008026:Ligation / Q000379:methods; D008297:Male; D009767:Obesity, Morbid / Q000523:psychology / Q000601:surgery*; D012649:Self Concept; D013270:Stomach / Q000601:surgery*; D016896:Treatment Outcome