title: Preparation of a severely obese adolescent for significant and long-term weight loss: an illustrative case.
abstract: For severely obese patients planning bariatric surgery, many surgeons advise pre-operative weight loss which can be difficult for some to achieve. We report a 16-year-old male who was referred for weight loss surgery in a very late stage of severe obesity with a weight and BMI of 310 kg and 93 kg/m(2), respectively. He also suffered from obstructive sleep apnea and hypertension. To prepare him for laparoscopic gastric bypass, a strict pre-operative nutritional intervention with inpatient and outpatient phases was designed. He lost 22 kg pre-operatively and an additional 86 kg by 67 months post-operatively, representing a 35 % total reduction in BMI. This case illustrates the feasibility and value of a defined pre-operative dietary intervention to effectively manage the weight of an adolescent referred late in the progression of severe obesity.
authors.affiliation: Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229-3039, USA. akruger43@midwestern.edu
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Kruger
authors.forename: Kathleen B
authors.initials: KB
authors.lastname: Hrovat
authors.forename: Stavra A
authors.initials: SA
authors.lastname: Xanthakos
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Inge
mesh_terms: D000293:Adolescent; D015390:Gastric Bypass; D006801:Humans; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D011300:Preoperative Care / Q000379:methods*; D013997:Time Factors; D015431:Weight Loss