What question did this study set out to answer?

The review aims to explore surgical and endoscopic interventions for obesity in pediatric and adolescent patients.

March 3, 2026Open Access

From Surgery to Endoscopy: Comprehensive Review of Bariatric Approaches in Pediatric and Adolescent Patients

Puntos clave

The review aims to explore surgical and endoscopic interventions for obesity in pediatric and adolescent patients.
Conducted a structured search in multiple scientific databases.
Included studies on bariatric and endoscopic interventions for patients aged 21 years and younger.
Extracted data on weight loss, BMI reduction, metabolic outcomes, and adverse events.
Bariatric surgery, especially sleeve gastrectomy and Roux-en-Y gastric bypass, shows substantial durable weight loss and high comorbidity remission rates.
Endoscopic sleeve gastroplasty has demonstrated preliminary short-term efficacy and safety, though evidence is limited.
Intragastric balloons offer a reversible, non-surgical option with consistent short-term weight loss, but long-term results vary based on behavior adherence.

Resumen

Background and Objectives: Pediatric and adolescent obesity is a growing global health concern that is often associated with cardiometabolic comorbidities. Lifestyle interventions represent first-line therapy; however, many adolescents with moderate-to-severe obesity fail to achieve clinically meaningful weight loss. The objective of this review is to provide a comprehensive overview of surgical and endoscopic interventions for adolescent obesity. Materials and Methods: A structured search of PubMed, Scopus, Web of Science and the Cochrane Library was conducted. Studies reporting outcomes of bariatric surgery (sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), adjustable gastric banding (AGB)) and endoscopic interventions (endoscopic sleeve gastroplasty (ESG) and intragastric balloons (IGBs)) in patients ≤ 21 years were included. Data on weight loss, BMI reduction, metabolic outcomes, adverse events and follow-up were extracted and summarized. Results: Bariatric surgery remains the most effective intervention, with SG and RYGB achieving substantial and durable weight loss and high rates of comorbidity remission. ESG is an emerging intervention with preliminary short-term efficacy and safety data, though evidence is limited to small pediatric cohorts. IGBs provide reversible, non-surgical weight reduction with consistent short-term efficacy, but long-term durability is variable and largely dependent on adherence to behavioral programs. Across all interventions, psychosocial support, family involvement and multidisciplinary care significantly influence the outcomes. Conclusions: Procedural interventions play a pivotal role in adolescents with moderate-to-severe obesity. IGBs could represent a minimally invasive, reversible option, particularly as bridging or adjunctive therapy. Prospective, long-term studies are needed to optimize patient selection, evaluate developmental safety and determine sustainable outcomes.

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