Background

Rates of severe obesity and prevalence of weight loss surgery (WLS) among adolescents have increased. This study examines initial anthropometrics (i.e. percent of the 95th percentile, %BMIp95) of patients who present for evaluation to an adolescent WLS program.

Methods

146 ethnically diverse (56.9% Hispanic, 26.7% Non-Hispanic Black (NHB), 14.4% Non-Hispanic White (NHW), 2% Asian) patients (M Age = 15.28, SD = 1.79; 61.6% Female) presented for an initial evaluation to an adolescent WLS program between January 2023 - December 2023. All patients met referral eligibility for WLS of Class II obesity with co-morbidity or Class III obesity.

Results

13% of patients presented with Class II obesity (120-139%BMIp95). 87% of patients presented with Class III obesity (>=140%BMIp95), with many patients presenting with exceptionally higher %BMIp95: 24.4% with 140-159%BMIp95, 29.9% with 160-179%BMIp95, 14.6% with 180-199%BMIp95, and 18.1%with >=200%BMIp95. There were no age or sex differences in %BMIp95, but NHW patients had higher %BMIp95 than NHB and Hispanic patients, F(2, 138) = 3.41, p <.05.

Conclusions

Patients in an adolescent WLS program present with significantly greater obesity severity than specifically recommended by pediatric obesity management clinical practice guidelines. WLS should be readily considered for adolescents when indicated, as early intervention can result in lasting quality of life benefits, and patients seen with exceptionally high weight may face additional barriers to completing WLS. Future research should examine relationships between adolescent obesity severity and WLS completion, and barriers to patient interest and provider referral for adolescent WLS programs.