Is there a place for bariatric surgery in childhood obesity?

Abstract

The media has long been fascinated by the implications and newsworthiness of the current epidemic of childhood obesity in this country. The media response to the publication of the National Institute for Clinical Excellence guidelines1 on obesity seemed to concentrate principally on the report's directions regarding the use of obesity (bariatric) surgery in childhood to the virtual exclusion of all else. In many ways the media missed the salient worry in this area: how to address obesity management in the vast majority of children requiring support in changing lifestyle behaviours with so few, effective centres for such work in the United Kingdom. In point of fact the NICE guidelines were extremely conservative in their approach to obesity surgery in children, mindful that this is an invasive intervention for what is essentially still a morbidity founded on lifestyle behaviours and decisions.