A multidisciplinary pediatric-adult transitional care framework for bariatric surgery in adolescents at a single academic center

Aim : Access to bariatric surgery in adolescents remains limited despite the burden of obesity. This study evaluates outcomes in adolescents who underwent bariatric surgery at a single academic institution, highlighting the essential role of the multidisciplinary team in managing this vulnerable population. Methods : This retrospective review included adolescents who underwent bariatric surgery at the McGill University Health Centre between 2018-2024. Patients were assessed through the Centre of Excellence in Adolescent Severe Obesity (CEASO) and referred for surgery following multidisciplinary evaluation. Baseline demographics, comorbidities, BMI, and postoperative outcomes were recorded. Descriptive statistics are shown as count (percentage) or median (range). Results : Of the 157 adolescents aged 13-18 years assessed by CEASO, 38 (24%) were referred for bariatric surgery, of whom, 26 (∼70%) underwent surgery with a median baseline BMI of 46 (37-88) kg/m². Sleeve gastrectomy was performed in 25 patients (96%), and one underwent Roux-en-Y gastric bypass. One patient required a second-stage single anastomosis duodenal switch for refractory diabetes and suboptimal initial weight loss. Median follow-up was 37 (14-93) months, with 91% follow-up at ≥3 years among eligible patients. Retention rate into adult follow-up among eligible patients was 96%. At last follow-up, median percent total weight loss was 28% (5-49). No 30-day postoperative complications were reported. Conclusion : In this small single-center cohort, adolescent bariatric surgery performed within a multidisciplinary pediatric-adult transitional care pathway was safe and effective. Larger prospective studies with standardized nutritional, psychosocial, and longer follow-up are needed before broader conclusions about safety and effectiveness can be drawn.