Department of Research & Evaluation News

In a Kaiser Permanente Southern California study, 1 in 23 adolescents met the eligibility criteria for metabolic and bariatric surgery, also known as weight loss surgery. The findings suggest that about 1 million adolescents across the United States could be eligible for the procedure.

“Understanding the population of adolescents who qualify for weight loss surgery is essential for informing how to most beneficially deliver this type of care,” said co-senior author of the study Corinna Koebnick, PhD, MSc, of the Kaiser Permanente Southern California Department of Research & Evaluation.

Metabolic and bariatric surgery changes the digestive system to help patients lose weight. It can be a safe, effective option for adolescents with severe obesity who meet specific eligibility criteria. However, there was limited data on how many adolescents qualify.

Research cohort included more than 600,000 teens

To help clarify, Dr. Koebnick and colleagues looked at the electronic health records of more than 600,000 teenagers ages 13 to 17 at Kaiser Permanente Southern California between January 2018 and December 2021. Eligibility for metabolic and bariatric surgery for adolescents is based on the severity of their obesity along with their other chronic health conditions

The researchers found that 4.4% of the patients studied met the eligibility criteria for metabolic and bariatric surgery. Male, Black, and Hispanic adolescents were more likely to be eligible, as were patients living in more socioeconomically deprived neighborhoods. Based on their findings, the researchers estimate that between 970,000 and 1.1 million U.S. teenagers may be eligible. The findings appeared in Pediatrics in February 2024.

“It is important to note that eligibility is just one of many factors in the decision of whether an individual teen should undergo weight loss surgery,” Dr. Koebnick said. “Overall, our findings emphasize the urgency of addressing and preventing obesity in adolescents.”

Lifestyle changes essential to weight loss

Poornima Kunani, MD, is a pediatrician and researcher at the Kaiser Permanente Manhattan Beach Medical Offices, is co-lead author of the study. She noted, “Whether surgery or medications are used, evidence-based treatment addressing lifestyle and behavior is essential for successful management of severe obesity.”

“Parental education, involvement, and support are also crucial, and schools play an essential role in nutrition, exercise, and access to mental health interventions,” she added.

Dr. Koebnick and Dr. Kunani are now researching the proportion of adolescents whose obesity resolves without weight loss surgery and the role of lifestyle treatment and weight loss medications. Weight loss medications have emerged as a promising option, in addition to lifestyle treatment, for management of obesity for young people.