Bariatric surgery is emerging as a safe and efficacious treatment for adolescent severe obesity, yet the durability of improvements and impact on patient well-being in the longer-term is largely unknown. This is a critical gap given adult evidence that patterns of optimal and suboptimal weight loss outcomes extend across the first post-operative decade or more, as well as by increased rates of alcohol use disorder (AUD) and risk of death by suicide. Unlike an adult, the adolescent patient's post-operative course cuts across known developmental periods where mental health disorders first emerge, and high risk behavior engagement peaks, including alcohol/tobacco/drug use, HIV/sexual-risk behaviors, and suicidal behaviors. Hence, tracking only adolescent physical health outcomes following bariatric surgery does not sufficiently capture the
/Relevance to Public Health: Bariatric surgery is emerging as a safe and efficacious treatment for adolescent severe obesity, yet the durability of improvements and impact on patient well-being in the longer- term is largely unknown. Unique to the adolescent (vs. adult) patient is a post-operative course that cuts across transitional developmental periods, where mental health disorders, HIV/sexual-risk behaviors, alcohol/tobacco/drug use, and suicide risks are high priority health issues, and from which this patient group is not spared. Successful completion of the proposed controlled longitudinal observational (continuation) study of the adolescent patient with severe obesity who underwent bariatric surgery will reveal 10-year, young adult outcomes of these public health priorities in the context of weight loss, weight status, physical health, and quality of life to inform clinical practice guidelines for this specific age group and vulnerable population.
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