| Summary: | National Institute of Health and Care Excellence (NICE) guidelines from the United Kingdom (UK) and International Pediatric Endosurgery Group (IPEG) guidelines state that weight loss surgery should only be considered in exceptional circumstances for obese children, and that the child must be physically mature and have failed 6 months of multidisciplinary lifestyle intervention. Eligibility criteria are stricter for youth than for adults. That is, only severely morbidly obese or morbidly obese children with serious comorbidities that would improve with weight loss are typically considered. Also, guidelines stipulate that surgery must be carried about by a multidisciplinary team with pediatric expertise. The high rate of obesity coupled with increasing numbers of surgeries performed may increase awareness and interest in the procedure. The Canadian Institute for Health Information (CIHI) reported that from 2012 to 2013 approximately six thousand bariatric surgeries, costing $48 million CAD (excluding physician compensation and non-hospital costs), were performed in Canada; a fourfold increase over six years. The majority of evidence on obesity and bariatric surgery in Canada is based on adult populations; however, the number of younger patients interested in and undergoing surgery has grown. Bariatric surgery has been demonstrated to improve weight loss, health, and psychosocial outcomes in adolescents; however, there is limited knowledge regarding its effect relative to alternative surgical procedures or non-surgical interventions. Thus, this review seeks to assess the comparative clinical and cost-effectiveness of bariatric surgery versus viable comparators in the adolescent and young adult population, and to review current evidence-based guidelines regarding the use of bariatric surgery in the adolescent population
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