Metabolic surgery in severely obese adolescents: which technique provides the best benefits?

Obesity is a public health and global health problem due to the disease burden it generates across all age groups, as well as being a pandemic due to its high prevalence worldwide. Bariatric surgery has traditionally been described as an aggressive option in the adolescent population. However, as the evolution of these patients over time and the improvement in health outcomes have been rigorously analyzed, it is positioned as an effective and safe intervention. Recently, novel high-quality evidence has emerged, sparking international scientific discourse on which techniques provide the most benefits and are safer in bariatric surgery for adolescents with severe obesity. Then, the aim of this review was to analyze the most recent clinical evidence, based on study designs, regarding clinical and surgical outcomes obtained by surgical techniques used during bariatric surgery in the management of severe obesity in adolescents. After the literature review, it was identified that surgical resolution for severe obesity in adolescents is effective and safe, with better benefits observed when using Roux-en-Y gastric bypass. There is a similar frequency of adverse events compared to sleeve gastrectomy and gastric banding. Micronutrient deficiency is the primary adverse event, which is potentially preventable and treatable.