Association of Youth Triponderal Mass Index vs Body Mass Index With Obesity-Related Outcomes in Adulthood

conducting a secondary analysis of data previously collected by the Teen Longitudinal Assessment of Bariatric Surgery and Treatment Options of Type 2 Diabetes in Adolescents and Youth trials 4 found adolescents with severe obesity treated with MBS had better weight loss, glycemic control, and improvement of cardiovascular risk markers than those receiving medical treatment alone.Despite these findings, less than 0.04% of children and adolescents with severe obesity are treated with MBS each year.Prospective studies comparing surgical therapy with medical management of severe pediatric obesity are lacking.However, the promotion of choices targeting improved health for these patients are universally advocated.Referral for multidisciplinary evaluation should be considered early in the disease process, especially among those children and adolescents with type 2 diabetes or other obesity-related comorbidities.The possible causes for the low rate of surgical management among this population are multifactorial and include a likely overestimation of the short-and longterm risks of MBS along with an underrecognition of the long-term detrimental consequences of pediatric obesity.5,6 An additional factor that greatly hinders appropriate referral for surgical evaluation is an inadequate number of multidisciplinary programs willing to treat pediatric patients.In the end, a large population of pediatric patients with severe obesity are not referred to and/or do not have access to the best care for their disease, to include a discussion of MBS.One key limitation of our study is our inability to examine long-term postoperative outcomes and complications with NIS and KID, both of which do not link multiple admissions of 1 patient and instead treat them as separate discharges.We can therefore only comment on in-hospital morbidity and mortality, keeping in mind the former is greatly affected by known coding limitations of all Healthcare Cost and Utilization Project databases.Nevertheless, NIS and KID are known to contain accurate procedure coding; hence they provide a reasonable overview of the current trends in types of surgical procedures, which was the primary goal of this study.